Preamble

The House met at half-past Two o'clock

PRAYERS

[Mr. SPEAKER in the Chair]

Oral Answers to Questions — MINISTRY OF DEFENCE

Services (Manpower)

Mr. Wingfield Digby: asked the Minister of Defence what percentage of the working population is now either in the Services or supporting them; and how this compares with three years ago.

The Minister of Defence (Mr. Harold Watkinson): The percentage of the working population now in the Services or supporting them is estimated at 4· 7 per cent. This compares with 60 per cent. three years ago.

Mr. Digby: Is it not a fact that in the 1957 White Paper on Defence the figure was no less than 7 per cent.? Does not this show that the Defence Services have made a big contribution to the economic difficulties of the country? Will my right hon. Friend make representations accordingly to the Chancellor of the Exchequer?

Mr. Watkinson: I am very grateful to my hon. Friend for what he has said. It is perfectly true that the Services have carried out a very painful operation in trying to reduce their dependence on the manpower of our working population.

Mr. H. Hynd: Would it not be more realistic to quote numbers rather than percentages?

Mr. Emrys Hughes: And cost.

Mr. Watkinson: No, I think that the percentage gives a fair figure.

Defence Board (Meetings)

Mr. Wingfield Digby: asked the Minister of Defence how often the Defence Board met in 1959 and 1960. respectively.

Mr. Watkinson: It is not in accordance with custom to give details of the working of committees of this sort. The Board meets as business requires.

Mr. Digby: Can my right hon. Friend say whether this new Board has given him assistance in formulating policy as was envisaged in the White Paper two or three years ago, following which the Board was set up?

Mr. Watkinson: Yes, Sir. I am glad to do that. I find the work of the Defence Board absolutely invaluable in helping me to consult my colleagues and formulate policy by general agreement, which is my wish.

German Forces (Facilities, United Kingdom)

Mr. Greenwood: asked the Minister of Defence what stage has been reached in the negotiations for the provision of facilities for German forces on British soil.

Mr. Frank Allaun: asked the Minister of Defence what proposals have been made recently by West Germany for military bases and training facilities in Great Britain; what help he has offered; and if he will make a statement on his discussions with General Heusinger.

Mr. Swingler: asked the Minister of Defence what form of agreement was signed on German bases in Great Britain on the occasion of General Heusinger's recent visit to this country.

Mr. Donnelly: asked the Minister of Defence whether he will make a statement regarding the arrangements that have been made for the training of West German armed forces in the Castlemartin area of Pembrokeshire.

Mr. Fernyhough: asked the Minister of Defence how many Federal German Service men will be stationed in Great Britain under the recent arrangement.

Mr. Lipton: asked the Minister of Defence what additional facilities he is providing for training German troops in Great Britain.

Sir B. Janner: asked the Minister of Defence whether he is aware that since the conversations between Her Majesty's Government and General Heusinger anxiety has increased about the admission


of German forces into Great Britain for training or other purposes; and what steps he now proposes to take to prevent their admission from taking place.

Mr. Watkinson: As the House knows, the Federal German Government have recently concluded arrangements through N.A.T.O. for storage and training facilities in other N.A.T.O. countries which cannot be met within their own territory. Discussions will shortly be taking place between the Germans and ourselves under the auspices of N.A.T.O. to see whether similar facilities can be provided in this country. Until these discussions have taken place, we do not know whether we can meet the needs of the German forces. The visit of General Heusinger to this country was not connected with these discussions.

Mr. Greenwood: Is the Minister aware that most people in this country hate this proposal and will be shocked by his Answer? Is there no hope of the discussions breaking down, or is the right hon. Gentleman determined to go down in history as the man who succeeded where Hitler failed and put German troops on British soil?

Mr. Watkinson: The hon. Member, of course, knows, first, that that is a completely misleading supplementary question, and, secondly, that it does not represent the views of the enormous majority of the population of this country. At any rate, let me make the Government's decision quite plain. The Government welcome wholeheartedly the German desire to incorporate their armed forces with their N.A.T.O. allies.

Mr. Allaun: Will the Minister give the House two very reasonable undertakings? The first is that no high-ranking former Nazi officers will be allowed here. The second is that no training will be given in the use of missiles or nuclear weapons.

Mr. Watkinson: I am not prepared to give any undertaking. What I said some time ago, and perhaps I may remind the House of it, was, first, that certain limited training of German personnel has already taken place, and I said then that if this was to be largely increased I would certainly undertake to inform the House.

Mr. Swingler: It the Minister really not aware of the widespread opposition in Britain to the growing armed forces in Germany? Is he not aware that a large number of people in Britain believe that the Government should devote themselves wholeheartedly to limiting armed forces and armaments in Germany, both East and West? Will he not, therefore, devote himself to that task?

Mr. Watkinson: That is a quite different question which should be put down to the Foreign Secretary.

Mr. Lipton: If the Germans have not enough room in their own country, would it not be much more sensible to bring back here the British forces at present in Germany and let the Germans do in their own country whatever training N.A.T.O. or their present Government want them to do? Would not that be a very much more sensible way of dealing with the problem, which will cause very grave disquiet, if not disgust, among many good British citizens?

Mr. Watkinson: I agree that this is an emotional subject for most of us; most of us have memories of one war, and some of us have memories of two wars. All I would say is that those who want to ensure that such a terrible tragedy cannot happen again should very strongly support the integration of Germany's forces with her allies.

Sir B. Janner: Does the right hon. Gentleman realise that the introduction of forces from Germany into this country will cause very serious anxiety to people who have suffered from the Nazis and are now in this country, particularly as there is a neo-Nazi party being recreated in Germany, as he probably knows? What steps will he take to ensure that the German forces which are brought into this country will be properly vetted so that they will not cause any damage, even if he will not stop them from coming altogether? Will he bear in mind that when in the past people of a similar nature have been allowed to come here they have on occasion indulged in the publishing of anti-semitic and other Nazi vicious propaganda here? Will he take that into consideration?

Mr. Watkinson: I wonder whether the hon. Gentleman has studied the extreme care with which the Federal German Republic acted when its forces took over certain training facilites in France. I am advised that, as a result, no trouble or difficulties arose, and there are certainly as deep feelings in France on this matter as in Great Britain.

Mr. Fernyhough: Will not the right hon. Gentleman acknowledge that this is really a Gilbertian situation? We are having to offer the Germans facilities to train their troops here because they have not enough room at home, while we have 50,000 or 60,000 troops stationed in Germany. Would it not be sensible to follow the advice given by my hon. Friend the Member for Brixton (Mr. Lipton)? Does the right hon. Gentleman realise that if he did so he would save more for the British taxpayer than the mean, miserable economies which the Minister of Health is now determined to impose on the babes, the maimed and the sick?

Mr. Watkinson: The hon. Gentleman will have an opportunity to pursue that subject later.

Mr. Costain: Is my right hon. Friend aware that I have had a letter from the Mayor of Lydd, a town which has a military camp, saying that certain members of his community would welcome German troops going there for training?

Mr. Watkinson: There are, as my hon. Friend the Member for Folkestone and Hythe (Mr. Costain) has fairly indicated, two sides to this question. I would ask hon. Members, who have a perfect right to feel deeply on this subject, just to reflect on the fact that none of us wants the tragedy of the last two world wars to happen again. Surely the best way to ensure that that does not happen is to try to tie the Germans tightly into our Western Alliance, and that is the wish of the Germans themselves.

Expenditure

Mr. Frank Allaun: asked the Minister of Defence if he will now reduce present arms expenditure.

Mr. Watkinson: As I informed the hon. Member for Wednesbury (Mr. Stonehouse) on 1st February, I see no

prospect of significantly reducing defence expenditure until there is an international agreement on disarmament or a real lowering of international tension.

Mr. Allaun: Is it not a fact that the annual military expenditure has risen from £770 million in 1950 to approximately £1,620 million today, which may explain the present National Health Service cuts? Can the Minister at least give us an assurance that reports of yet another increase in this year's Estimates to £1,700 million are false?

Mr. Watkinson: It is not customary to anticipate the White Paper on Defence. When the hon. Gentleman sees it, he may find that we have done a little better than he thinks.

Polaris Submarine Base

Mr. Emrys Hughes: asked the Minister of Defence, in view of the relaxation of international tension as a result of the release of the RB47 airmen, if he will now reconsider the decision to agree to a Polaris base in Great Britain.

Mr. Watkinson: No, Sir. Her Majesty's Government welcome this gesture by the Soviet Government but reductions in the defences of the Western Alliance can only flow from agreed measures of disarmament.

Mr. Hughes: Does the right hon. Gentleman agree that it is a curious welcome to proposals which are likely to reduce international tension to establish this atomic monster on the Clyde? Does he not realise that this monster is designed to destroy the civil population of the Soviet Union, and that the result might be the destruction of this country? Does he not think that some gesture of this kind would be heartily welcomed in Russia and certainly in Scotland?

Mr. Watkinson: The hon. Gentleman and I could not be further apart, because we disagree on the basic contention. It is my contention, and that of, I think, all reasonable people, that the Polaris submarine weapon system, because it is a second-strike weapon, makes the chance of war much less likely.

Mr. G. Brown: asked the Minister of Defence whether he is aware that, now that the United States Government has decided to reduce the number of Service families allowed to be stationed


abroad, there is no longer a similar need for housing, schools and similar facilities to be available near to a Polaris submarine base; and whether the Government will now reconsider the decision to have a base at Holy Loch.

Mr. Watkinson: The nearness of housing and schools was not the determining factors in choosing the Holy Loch, though it was one of several factors. In any event, President Kennedy's statement of 1st February makes it seem unlikely that families wishing to join members of the crew of the depot ship will be prevented from doing so.

Mr. Brown: I saw that President Kennedy had let me down. Nevertheless, would it not be sensible to look at this again to see whether the technical facilities required cannot be provided somewhere else and prevent, as we all know, this housing requirement being the determining factor in putting this base so near a very crowded urban area?

Mr. Watkinson: I quite see the point of the right hon. Gentleman's supplementary question. This was gone into very carefully, but perhaps I should make it plain, because a great many people are creating a misleading impression by saying that this is a base. What it is is a few buoys in a sea loch to which a depot ship will moor, and nothing could be more mobile than that. Certainly at the present time this seems to be the best anchorage that can be provided, for a whole range of very technical reasons, and that is why it is going there.

Sir A. V. Harvey: In considering this matter, will my right hon. Friend take into account the matter which is today before the British courts and is sub judice?

Mr. Watkinson: I take note of my hon. Friend's point.

Nuclear Weapons

Mr. Swingler: asked the Minister of Defence if, in the forthcoming White Paper on Defence, he will state whether it is still Her Majesty's Government's policy to initiate the use of nuclear weapons in certain circumstances.

Mr. Warbey: asked the Minister of Defence whether, in the forthcoming White Paper on Defence, he will include

an estimate of the proportion of total defence expenditure which is accounted for by nuclear weapons and their means of delivery, including expenditure on research and development.

Mr. Watkinson: It is not customary to disclose in advance the contents of the White Paper on Defence and I must. therefore, ask the hon. Members to wait until it is published.

Mr. Swingler: As the right hon. Gentleman still has some time to give very serious consideration to this in view of the further development of rockets and nuclear weapons since this doctrine was first enunciated, and in view of the utterly suicidal nature of this doctrine for this country now, will he consider inserting something in the White Paper to show that he has returned to sanity and abandoned his policy?

Mr. Watkinson: The hon. Member had better await the White Paper.

Mr. Warbey: Would not the right hon. Gentleman agree that if we were to eliminate the nuclear element from our strategy the savings realised would be sufficient to pay for the necessary expansion of scientific and industrial research and of our health, education and welfare services without imposing a single penny of extra burden on the taxpayer, the insured contributor, the patient and the consumer?

Mr. Watkinson: No, Sir; I would not. The hon. Gentleman will see that for himself if he bothers to look at the figures.

Mr. S. Silverman: Has the right hon. Gentleman seen the statement recently made by the President of the United States of America that in no circumstances would they fight first? Does he not appreciate that the British Government's intention, as set forth in a former Defence White Paper, that in some circumstances they would strike first creates a fundamental division between the defence policy of the Government and that of their principal ally in N.A.T.O.?

Mr. Watkinson: There will probably always be varying views about what has been written in the past, but over a whole series of White Papers it has been clearly said time and time again that this country would never be an aggressor.

Mr. Mayhew: asked the Minister of Defence what steps he is taking to ensure that the British Army of the Rhine is fully organised, equipped, trained and deployed to meet threats to peace in Europe without recourse to nuclear weapons.

Mr. Watkinson: In dealing with aggression, N.A.T.O. forces would not necessarily have recourse to nuclear weapons. B.A.O.R., as the United Kingdom's land force contribution to N.A.T.O., is organised, equipped, trained and deployed to meet the N.A.T.O. military authorities' defence plans, which call for both nuclear and conventional capacity.

Mr. Mayhew: But is it not rather a disturbing fact that the B.A.O.R. as at present organised and trained is virtually incapable of operating in any conventional rô le? Is it not a fact that all the B.A.O.R. exercises last year were held on the assumption of the use of nuclear weapons? Is not this contrary to General Norstad's own policy?

Mr. Watkinson: The B.A.O.R. exercises last year were, as they will be this year, in exact accordance with the Supreme Commander's doctrine, and that is that we must be prepared to use either nuclear or conventional weapons as circumstances dictate.

Mr. P. Noel-Baker: Will the Minister consider circulating in the OFFICIAL REPORT public statements made by British officers with the B.A.O.R. about the use of nuclear weapons?

Mr. Watkinson: I think that there is a Question down to my right hon. Friend on that subject. What I must make plain on the broad policy issue is that there is no change and that we work as loyal members of N.A.T.O. to the directives, both political and military, laid down by the Alliance, and we have not departed or budged from that.

Service Men (Records)

Mr. Parkin: asked the Minister of Defence what records are kept by Service Departments of a Service man's race or mixture of races.

Mr. Watkinson: Such information is recorded as is necessary to ensure that coloured members of the Forces are not

sent to areas where they may be denied equal treatment with their white comrades.

Mr. Parkin: In view of that rather startling reply, which shows that the Service Departments have now adopted a policy which the Ministry of Labour and the Ministry of Pensions and National Insurance have refused to undertake, would the right hon. Gentleman care to enlighten the House a little more about the methods of recording the selections? Is there a colour chart distinguishing between "medium oak" and "dark oak"? Are there some ancestral notes? Are relatives to come into it? Does the nature of a kink in the hair come into it? What bogus racial doctrine is followed in compiling these statistics?

Mr. Watkinson: The hon. Gentleman knows as well as I do that the reason for this is the very sensible one that it is the duty of a commanding officer to look after the men under his command and to ensure that they are not subjected to unpleasantness when serving in the Forces of the Crown.

Mr. Thorpe: Is the right hon. Gentleman satisfied about the accuracy of these racial records? Is there, for example, a right of appeal by a person who is, in his view, classified incorrectly? Would it not perhaps be advisable for the right hon. Gentleman to have consultations with the High Commissioner for South Africa, who has far greater experience in these things and no doubt would assist?

Mr. G. Brown: Is the Minister aware that this is a most serious reply? It seems to conflict completely with the Prime Minister's reply yesterday. Will the Minister give us a list of the places to which our coloured fellow citizens are not sent, and will he review it with the Prime Minister to see whether the Government want to adhere to this policy?

Mr. Watkinson: My right hon. Friend the Prime Minister said yesterday that we would look at this whole question, but the point I am on is a perfectly proper one for the Minister of Defence or Service Ministers whose first duty—as the right hon. Gentleman knows there is no colour bar at all in Her Majesty's Forces


and no discrimination between race, colour or creed—is to see that these men, when they are on duty, are properly looked after and not subjected to any improper treatment or put in an embarrassing situation.

Mr. Brown: The Minister has not answered the second part of my supplementary question. Will he give the House a list of the places to which coloured members of the Services are not sent?

Mr. Watkinson: If the right hon. Gentleman wants to pursue that, perhaps he will put down a Question. It would be very difficult to give an exact list because this is purely a matter for the discretion of the Service, or sometimes of the commanding officer, to try to see that the men are not put in an embarrassing position

Fighter Command

Mr. Rankin: asked the Minister of Defence if he will state the nature and give the text of the safeguards which protect British national interests in the plan to put Fighter Command under North Atlantic Treaty Organisation control.

Mr. Watkinson: Great Britain retains the right to decide the size, composition, rô le and deployment of their air defence forces assigned to SACEUR.

Mr. Rankin: May we take it from that Answer that we will have complete control over the use of Fighter Command for non-N.A.T.O. purposes? Can the Minister tell us how many aircraft will be involved? Can he say how many Hunters and Lightnings and so on will be involved in this? If we can abstract our Fighter Command at any time for our purposes, how will that affect the purpose for which this integration is being made, which I presume is an attempt to provide defence in depth?

Mr. Watkinson: The last part of the hon. Gentleman's supplementary question sums it up very well. It is entirely to deploy the defence in depth which the change in the air situation makes necessary. If he will be kind enough to study the words used in my original Answer, the hon. Gentleman will see that this gives us complete control over our own

fighter forces. For many years we have been pressing in N.A.T.O. not for integrated defence, but for unified air defence, and that is what we have now secured.

Caribbean Area (Defence Arrangements)

Mr. Chetwynd: asked the Minister of Defence whether he will hold an investigation into the inadequacy of United Kingdom defence arrangements in the Caribbean area, in view of the weakness of United Kingdom detection methods, as revealed in the lengthy search for the "Santa Maria".

Mr. Watkinson: No, Sir.
The search for the "Santa Maria" revealed no inadequacy in United Kingdom defence arrangements in the Caribbean.

Mr. Chetwynd: How can the right hon. Gentleman make that outrageous statement when it took almost four days to find out where this great vessel was, maintaining complete radio activity? What would have happened had it been a hostile submarine submerged and maintaining radio silence? We should not have found it yet.

Mr. Watkinson: I do not know whether the hon. Gentleman served at sea, as I did, during the last war. if he did, I think he will accept that an ocean is a very big place. As to the particular case which concerns a British frigate, it would have needed second or third sight on the part of the commanding officer to ascertain that, when he was quite justifiably in need of refuelling, the "Santa Maria" was about to sail.

Mr. G. Brown: Would it be a fair point to ask the Minister whether the commander should not be congratulated upon his obvious use of the Nelson touch to give Her Majesty's Government time to get their policy right?

Mr. Watkinson: I think what the right hon. Gentleman is saying is that this was a diplomatic running out of fuel. I am happy to assure him that it was an actual and very practical running out of fuel.

Mr. S. Silverman: What makes the right hon. Gentleman happy about that?

Services (Joint Planning)

Mr. H. Hynd: asked the Minister of Defence how much joint working has been achieved between the three Services.

Mr. Watkinson: Except for operations that by their nature concern only one Service, all operational planning is now carried out by the Services jointly; and their orders of battle and their equipment are planned as a whole. Their technical and administrative support is pooled wherever this is calculated to make for economy and efficiency.

Mr. Hynd: Is the Minister satisfied that sufficient progress has been made in that direction?

Mr. Watkinson: No, I am not entirely satisfied, and I hope to take it a good deal further before long.

N.A.T.O. (United States Proposal)

Mr. Millan: asked the Minister of Defence if he will make a statement on the Government's policy with regard to the United States proposal that the North Atlantic Treaty Organisation should be provided with a medium-range ballistic missile multilateral force.

Mr. Watkinson: No, Sir.

Mr. Millan: Is the Minister aware that there is still a great deal of vagueness about the proposal? Are not we entitled to know what the Government think about it? Is he aware that there is a considerable feeling that N.A.T.O. should not be made into a fourth nuclear power?

Mr. Watkinson: My right hon. Friend the Lord Privy Seal made a fairly full statement on the Government's present position on 20th December. I have nothing to add to that at the moment, because negotiations are still going on.

Mr. M. Foot: In view of the fact that nobody could understand the Lord Privy Seal's statement on that occasion, will the Minister now tell us whether the British Government are in fact so opposed to the proposal for putting some of these Polaris weapons into Europe?

Mr. Watkinson: I confess that I find equal difficulty in understanding the hon. Member's contribution to defence questions.

Mr. Speaker: Mr. Wall.

Hon. Members: Answer.

Mr. Speaker: Order. I have called the next Question. We are not getting on very well.

Royal Navy (Polaris Missiles)

Mr. Wall: asked the Minister of Defence whether he will arrange to purchase Polaris missiles for use in conventional surface or underwater warships of the Royal Navy.

Mr. Watkinson: There is no need for us to take an immediate decision in this matter.

Mr. Wall: Can my right hon. Friend say whether the installation of this weapon in conventional hulls is being considered? Would not this be a way of reducing costs? Has he noted that the Americans are installing this weapon in the cruiser "Long Beach"?

Mr. Watkinson: I have noted my hon. Friend's point, which is an important one.

Mr. Emrys Hughes: Is the Minister aware that one of these Polaris submarines costs £50 million? If he orders any more, will there have to be further cuts in the Health Services in order to pay for them?

Mr. Watkinson: I have not ordered any yet.

Officers (Training)

Mr. Wall: asked the Minister of Defence what steps he is taking to integrate the training of officers of the three Services at all levels.

Mr. Watkinson: It is my aim to extend joint Services training as much as possible, and I am now having the possibilities examined.

Mr. Wall: It may be good at the top level, but can my right hon. Friend give attention to the need for increasing this Service training at the Dartmouth, Sandhurst and Cranwell level?

Mr. Watkinson: I have great sympathy with the question of trying to integrate Service training. My hon. Friend may like to know that the whole subject is now being examined in great detail.

National Service

Mr. Dempsey: asked the Minister of Defence if, in view of the developing mobility of the Armed Forces, he will consider reducing the period of National Service for all National Service men.

Mr. Watkinson: No, Sir.

Mr. Dempsey: Does the Minister appreciate that as a result of increasing mobility it becomes quite desirable and practicable to telescope training facilities, thus reducing the period of National Service? Does not he realise that by doing so we could eliminate the wastage of many young Service men and release additional manpower in order to assist the country to face the present economic challenge?

Mr. Watkinson: We have released certain National Service men who, for reasons of the cut-down in training commitments, and other reasons, have become redundant. We will keep to that policy. But as I said in answer to the Question, I see no chance of cutting down the term.

Oral Answers to Questions — WIRELESS AND TELEVISION

North Lincolnshire (Reception)

Mr. C. Osborne: asked the Postmaster-General what is the estimated cost of setting up a satellite transmitter to enable the North Regional Home Service programmes to be better received in the North Lincolnshire area; in view of the large number of complaints his Department has received on this matter, what steps he is taking; and how soon they will be effective.

The Postmaster-General (Mr. Reginald Bevins): I have already authorised the British Broadcasting Corporation to provide a V.H.F. sound station in East Lincolnshire in the second stage of its satellite scheme, and this is expected to cover those parts of Lincolnshire not now adequately served by existing V.H.F. stations. All stations in this stage are due to be completed by March, 1964.
The cost will be of the order of £50,000.

Mr. Osborne: I am much obliged to my right hon. Friend for that promise. He hopes that the scheme will be completed by 1964. Cannot we have it a little quicker? Both viewers and listeners in North Lincolnshire feel that they are on the outer fringe of both the Northern

and the Midlands Service, and that they do not get a good service from either. Cannot this be completed a little earlier?

Mr. Bevins: The second stage will be finished by 1964, and I hope that that part of the programme with which my hon. Friend is concerned will be finished well before that.

Advertisements (Drugs)

Mr. Mayhew: asked the Postmaster-General what consultations he has had with the Independent Television Authority under subsection (5) of Section 4 of the Television Act, with a view to banning drug advertisements on Independent Television forthwith.

Mr. Bevins: None, Sir.

Mr. Mayhew: Is the Minister aware that the British Medical Association has now confirmed the suspicions of many viewers by stating that a number of medical advertisements on I.T.V. are bogus and misleading, and by recommending a ban on drug advertising on I.T.V.? Why, when the Minister has power to stop this very profitable abuse, does he constantly aid and abet it?

Mr. Bevins: I am well aware of the advice which the British Medical Association has put to the Pilkington Committee. It is, in the first place, a matter for that Committee to consider, and not for me, but in fairness I should point out that the I.T.A. is governed by the advice of its Advertising Advisory Committee, which includes representatives not only of the British Medical Association but of the British Dental Association, the Pharmaceutical Society and the Ministry of Health. The I.T.A. has repeatedly made it clear to the members of that Committee that if they feel that the standards of advertising are being infringed they should say so to the I.T.A.

Mr. W. R. Williams: Are we to assume from that reply that up to the present, at any rate, the Committee has not shown the same concern about this matter as has the British Medical Association? Secondly, in view of the general concern which is felt about this subject all over the country, does not he think that he should remit this matter specially to the Committee for its examination and reply?

Mr. Bevins: The answer to the first part of the hon. Member's supplementary question is "Yes". The answer to the second part is that this is the first occasion on which the B.M.A. has expressed this view.

Oral Answers to Questions — POST OFFICE

Post Box, Helensburgh

Mr. Steele: asked the Postmaster-General why he displays a poster indicating that the correct address of the locality is Helensburgh, Dumbartonshire, while the nameplate above the posting box is Helensburgh, Dunbartonshire.

The Assistant Postmaster-General (Miss Mervyn Pike): I am sorry about this discrepancy. The poster is being brought into line forthwith with the notice above the posting box. Further, this form of spelling will be adopted generally by the Post Office as soon as possible, a course which I am sure will be welcomed by the county council.

Mr. Steele: I thank the hon. Lady and her Department for at last adopting the spelling preferred by the County Council of Dunbartonshire, and I express my appreciation at the fact that the Post Office are no longer "Dumb".

Newspapers

Mr. Shinwell: asked the Postmaster-General what are the proportions between reading matter and advertising in newspapers which determine his decision to register such newspapers for postal purposes.

Miss Pike: Publications are accepted for registration as newspapers provided they contain at least one-third news matter or articles on current topics and that they satisfy the other requirements of registration.

Mr. Shinwell: Is the hon. Lady satisfied that this regulation is being carried out?

Miss Pike: Yes, Sir.

Mr. Shinwell: Can she produce any evidence that it is being carried out?

Miss Pike: I should be interested if the right hon. Gentleman would produce evidence to the contrary.

Oral Answers to Questions — TELEPHONE SERVICE

New Connections

Mr. W. R. Williams: asked the Postmaster-General whether the figures of expected growth of the telephone service set out in paragraph 14 of the White Paper on Post Office Capital Investment, 1960–61, Command Paper No. 973, still represent Post Office expectations; and whether he will make a statement.

Mr. Bevins: The Post Office capital allocation for 1960–61 has been increased by £2 million since the White Paper was published. I now expect to improve on the forecast in paragraph 14 of the White Paper. I hope that the number of new connections will be 465,000.

Oral Answers to Questions — EAST BERLIN (RECRUITMENT OF ARMED FORCES)

Mr. W. Hamilton: asked the Lord Privy Seal if he is aware that the East German Government is recruiting for its armed forces in East Berlin, and that this is a violation of the four-Power status of Berlin; and what has been the nature of Her Majesty's Government's protest.

The Lord Privy Seal (Mr. Edward Heath): Yes, Sir. The original Four-Power legislation forbidding military activities in Berlin, which continues to be observed in West Berlin, has long been ignored in the Soviet Sector. The Allies have frequently called the attention of the Soviet authorities to provocative military activities there.

Mr. Hamilton: Can the right hon. Gentleman say when the last protest was made by the British Government, and what the response to it was from the German authorities or the Four-Power Commission?

Mr. Heath: The last protest was made comparatively recently and the response was that to which the hon. Gentleman has called attention—the resolution of the East Berlin Assembly in December instructing the authorities in East Berlin to support recruitment.

Mr. Shinwell: How was it possible for the right hon. Gentleman to protest against this alleged action by the East German Government when we do not


recognise that Government? To whom was he protesting? Is the right hon. Gentleman aware that similar allegations have been made about the West German Federal Government's recruiting activities in West Berlin?

Mr. Heath: The protest can be made to the Soviet authorities, as one of the signatories to the quadripartite agreement. It is untrue that similar activities are being carried out by the Federal Government in West Berlin.

Mr. Rankin: Can the Minister tell us what protests have been received by our Government in respect of our violations of the Treaty of Potsdam, especially in regard to the arming of West German soldiers in this country?

Mr. Heath: If the hon. Member will put down a Question on that subject, I will answer it

Oral Answers to Questions — LAOS

Mr. Warbey: asked the Lord Privy Seal whether he has now received a reply from the Soviet Government to his proposals regarding the reactivisation of the International Commission for Supervision and Control in Laos.

Mr. Grimond: asked the Lord Privy Seal if, in view of recent international developments, Her Majesty's Govern-will now consult the United States of America with a view to the reconvening of the Geneva Conference on Indo-China.

Mr. Heath: No reply has yet been received from the Soviet Government, though Her Majesty's Ambassador in Moscow has been informed that it will not be long delayed. Meanwhile, I do not think that it would be helpful to put forward other proposals.

Mr. Warbey: Is not the real difficulty in this matter the lack of agreement on the question to whom the International Commission shall be accredited? Can the right hon. Gentleman say what proposals were made on this point to the Soviet Government and, secondly, whether or not Prince Boun Oum has now accepted the idea that the Commission should be accredited to neither of the rival Governments but to the King?

Mr. Heath: In putting forward these proposals we did our utmost to reach the

point of view—as we understood it—of the other co-Chairman and the other countries concerned. That is why we took a certain amount of time to reach agreement on this point. We must now wait to see what reply the Soviet Government make, and to see whether they accept our proposals. As for the Government of Laos, they have said that when the proposal is put to them from the two co-Chairmen they will consider it.

Mr. Healey: asked the Lord Privy Seal what protest he has made to the authorities in Laos regarding the false reports of large-scale intervention by foreign military units which they have circulated to members of the South East Asia Treaty Organisation.

Mr. Heath: None, Sir.

Mr. Healey: Surely this is a matter on which the Government should have made a formal protest? Is it not the case that the meeting of the S.E.A.T.O. Council was called in order to discuss the reports which have been circulated by the Laos authorities concerning foreign military intervention in Laos? Now that those authorities have admitted the reports to be completely false, are the Government going to do nothing whatever about it?

Mr. Heath: No, Sir. No such statements have been circulated by the Government of Laos to the S.E.A.T.O. Council. That is why we have not made any protest.

Mr. Warbey: Were not the statements taken up by the American State Department, issued as an official statement on which they said they had hard evidence and presented by them to the S.E.A.T.O. Council for action to be taken?

Mr. Heath: A variety of statements have been made in the Far East about the situation in Laos and intervention. We have always made our own assessment as to how much truth there was in them.

Oral Answers to Questions — CHINA (UNITED NATIONS MEMBERSHIP)

Commander Courtney: asked the Lord Privy Seal to what extent it is now the policy of Her Majesty's Government


to take such steps as may be practicable with a view to facilitating Chinese membership of the United Nations.

Mr. Heath: I have nothing to add to what my hon. Friend told the House on this subject during the debate on 12th December.

Commander Courtney: Is my right hon. Friend aware that on 28th January the Japanese Prime Minister stated in a public speech that Great Britain was against the entry of China into the United Nations? Will he take steps to correct this obviously erroneous impression?

Mr. Heath: I have not yet seen the full content of that speech. When I do, I will certainly see what action should be taken about it. Our own position was stated quite clearly in the speech to which I referred.

Mr. P. Noel-Baker: Will the Minister make it plain that, under the Charter, China is a member of the United Nations and that the question which arises is that of according to her the seat in the United Nations which is legally hers?

Mr. Heath: It is a question of which authority should occupy that seat.

Mr. C. Osborne: Will my right hon. Friend bear in mind that while the Communist Government in China is undoubtedly anxious to get its rightful seat in the United Nations, what it really requires above that is food, oil and the credits to buy them? Will he do his best to see whether we can help in this way rather than by trying to push at the United Nations?

Mr. Heath: As the House knows, the Government of the Republic of China is taking considerable action in world markets, but it has made no direct approach to us in this matter. Of course, if it did so we should consider the matter.

Mr. P. Noel-Baker: Did the right hon. Gentleman's last reply to me mean that he was really seriously suggesting that Formosa represents China?

Mr. Heath: The plain fact is that the Government in Formosa at present occupies the seat at the United Nations. On the other hand, the Government of Peking claims the seat and, therefore, it is a question of which authority should occupy the seat. That makes no judgment as to which one should.

Sir P. Agnew: Further to the reply he has already given, would my right hon. Friend bear in mind that if the People's Government of China is to be given a seat in the United Nations, recognition should not be withdrawn from the Government of China which occupies and rules over the island of Formosa, but that they should be given simultaneous recognition?

Mr. Heath: My hon. Friend has pointed out one of the difficulties of the situation. I should make clear to the right hon. Member for Derby, South (Mr. P. Noel-Baker) that our position was clearly stated in the speech of my hon. Friend in which, briefly, he said that we have extended recognition to the Peking Government and therefore, prima facie, one would expect that Government to be in the United Nations.

Oral Answers to Questions — CONGO

Food Supplies

Mr. Dodds: asked the Lord Privy Seal if he will investigate the circumstances surrounding the dumping, for several months, at the Royal Air Force airfield at Abingdon, of 8,000 tins of corned beef intended for starving people in the Congo; what it is now intended to do with the food; and if he will make a statement.

Mr. Heath: This corned beef was part of a supply set aside for the Congo last summer after an appeal from Mr. Hammarskjoeld for help in combatting food shortages in urban areas in the Congo. It proved to be surplus to the consignment which the aeroplanes undertaking the operation were able to carry. We have more than once been in touch with the United Nations authorities about the meat; and we have now heard that they do not require it for famine relief. We shall, therefore, dispose of it through Government channels and remit the net proceeds to the United Nations.

Mr. Dodds: Is not it a terrible thing that many months ago the people of the Congo were dying of starvation and that this food would have been very useful? Is not the right hon. Gentleman aware that a spokesman of United Nations, Mr. Norman Wright, said in Rome that he had never heard of it, and that this


food would have been of great value many months ago? Since someone has blundered and this mountain of beef is at the airfield, will the right hon. Gentleman have an investigation to find out who is responsible? Will he make a statement so that the public, which is deeply concerned, can know whether the authorities are looking after these things as they should in an emergency of this sort?

Mr. Heath: I have made a very clear statement as to how this corned beef came to be at the aerodrome. I have also said that on more than one occasion we approached the United Nations about this and it has informed us that it does not require the food, and therefore it is to be sold. We have been in touch with the F.A.O. about the statement to which the hon. Gentleman referred, and Dr. Wright categorically denies that he made that statement.

Mr. C. Osborne: Withdraw that one.

Mr. Dodds: In view of the statement made by the Minister and the need to have it thoroughly investigated, I beg to give notice that I shall raise the matter on the Adjournment.

Security Council Meeting

Mr. Fernyhough: asked the Lord Privy Seal if he will instruct Her Majesty's Government's representative at the United Nations to support the proposals recently made by Ceylon for dealing with the present critical situation in the Congo.

Mr. Healey: asked the Lord Privy Seal what new proposals Her Majesty's Government will make at the current meeting of the Security Council regarding the Congo situation.

Mr. Heath: The Security Council met again yesterday and has adjourned until 10th February at the earliest. Her Majesty's Government retain the belief that internal political and constitutional difficulties are, in the first instance, matters for the Congolese people to settle for themselves, and will give support to those measures which they believe will help the Congolese in this matter.

Mr. Fernyhough: Is the right hon. Gentleman aware that this is an abdication of British influence? Would he not

agree that the proposals put forward by Ceylon are realistic and are broadly supported by India? Is it not time, in this rather dangerous situation, that Her Majesty's Government began to show a little initiative?

Mr. Heath: These matters are still being discussed in the Security Council. Our views will be expressed on the proposals of the delegate from Ceylon, but our purpose is to help the Congolese to solve these problems themselves. That is not an abdication of leadership or of influence, but one must be quite clear about the United Nations trying to impose a solution on the people of the Congo, with all the consequences that would involve.

Mr. Healey: While there might be general agreement with the broad proposition which the Lord Privy Seal has adduced, is it not a fact that there has been a great deal of foreign intervention, particularly by Belgian personnel, in the affairs of the Congo, that the arrest of Mr. Lumumba was carried out by troops under Belgian orders and that he is now being held in a prison which is effectively under the control of Belgian personnel? In this situation, surely it is not enough for Her Majesty's Government to take refuge in a completely Pontius Pilate attitude?

Mr. Heath: Her Majesty's Government have always taken the view that intervention by outside Governments was excluded under the Security Council Resolution, but where authorities in the Congo themselves have recruited nationals from a whole variety of countries that is a matter of their own internal affairs.

Mr. Healey: Surely the right hon. Gentleman must be aware that if he takes this line there is nothing to prevent other Congolese authorities, such as Mr. Tshombe, inviting Soviet military personnel—and possibly military personnel from China—to strengthen their position? Surely the attitude taken by the Lord Privy Seal is the recipe for an international civil war in the Congo?

Mr. Heath: I cannot accept that that is the conclusion because of the fact that United Nations forces are there under the Security Council resolution to maintain order.

Military Assistance

Mr. Reynolds: asked the Lord Privy Seal if he will instruct the British representative on the Security Council to raise the purchase by the Katanga administration of French-built jet fighter aircraft, as a threat to peace in Africa.

Mr. Heath: The Government of France have announced that no such purchase has been made in France. It is, of course, the policy of Her Majesty's Government, in accordance with the General Assembly resolution of 22nd September, that any military assistance to the Congo should be supplied through the United Nations.

Mr. Reynolds: Is the right hon. Gentleman aware that while no such purchases have been made in France, these planes are alleged to be proceeding through France on their way to the Congo? Will he take steps to get further information and, if necessary, try to take action through the Security Council of the United Nations to avoid the shipment of quantities of modern arms into this area?

Mr. Heath: We are not in possession of the information which the hon. Member mentions, but I shall endeavour to find whether what he says is correct.

Mr. Healey: Is it not precisely this type of action in the Congo which has led Mr. Hammarskjoeld to say that unless it is stopped he will have to ask for the withdrawal of United Nations forces from the Congo? When are the Government going to open their eyes to the facts of the situation?

Mr. Heath: The eyes of Her Majesty's Government are very much open to the facts of the situation. It is a very great over-simplification of the case to say that this was the cause of the Secretary-General's statement on the matter

Oral Answers to Questions — BAHRAINI PRISONERS (ST. HELENA)

Mr. Stonehouse: asked the Lord Privy Seal if, in view of the legal complexities of the case of the three Bahraini political prisoners on St. Helena, Her Majesty's Government will take the matter to the Judicial Committee of the Privy Council for further legal opinion.

Mr. Heath: No, Sir.

Mr. Stonehouse: Why is the Minister continuing to play a cat-and-mouse game with these men? Why has he announced that he will contest legal action at every stage and so make it impossibly complicated and expensive for them? In view of the fact that the legal complexities have been caused by mistakes in his own Department, will not he assist to get this cleared up on his own initiative?

Mr. Heath: I am not playing a cat-and-mouse game with these men. I am as anxious to reach a solution to this problem as anyone. The legal complexities are not in any way caused by activities of the Foreign Office. Perhaps the hon. Gentleman will await the statement which, with the leave of the House, I propose to make at the end of Question Time.

Oral Answers to Questions — UNITED ARAB REPUBLIC

Egyptian Delta Light Railways (United Kingdom Stockholders)

Mr. Lindsay: asked the Lord Privy Seal what representations have been made to the United Arab Republic about compensation for the United Kingdom stockholders in the Egyptian Delta Light Railways; and with what results.

Mr. Heath: This case, which first arose out of the transfer of the control and management of this Company to Egypt in 1945, has, I understand, been taken up in the Egyptian courts on behalf of certain debenture holders and is still forming the subject of legal proceedings. In the circumstances it would not be appropriate for Her Majesty's Government to make representations in the matter to the Government of the United Arab Republic.

Dismissed British Officials (Compensation)

Mr. Lindsay: asked the Lord Privy Seal what further representations have been made to the United Arab Republic about compensation for the British officials summarily dismissed from the service of the Egyptian Government nine years ago; and with what results.

Mr. Heath: Repeated representations have been made and are still being made to the Government of the United Arab


Republic about compensation for these officials but so far Her Majesty's Government have not been informed that any decision has been reached.

Mr. Lindsay: Is my right hon. Friend aware that a number of these officials have already died; that the rest of them are getting on in age; that it is nine years since they were dismissed and that many of them have great difficulty in maintaining themselves? In view of the recently improved relationship between Great Britain and Egypt, which we welcome, will my right hon. Friend instruct our new Ambassador to take this up as a matter of priority and point out to the Egyptian Government that this is a matter in which the national honour of Egypt is very much involved?

Mr. Heath: Yes, Sir. I have every sympathy, and I know that the House has, for these former British officials. The Financial Agreement arranged that a commission would be set up to re-examine this subject. That was done in July last and we know that the commission has reported to the United Arab Republic Ministers, but, so far as we know, the Ministers have not reached any decision about it. I will, therefore, adopt the suggestion of my hon. Friend.

Oral Answers to Questions — DISARMAMENT

Mr. P. Noel-Baker: asked the Lord Privy Seal what was the result of the examination by the North Atlantic Treaty Organisation Standing Council of the two comprehensive disarmament plans put forward by the Union of Soviet Socialist Republics and United States delegates to the Ten Power Conference on 7th and 27th June, 1960, respectively; and whether he will make a statement.

Mr. Heath: The discussions of the North Atlantic Treaty Organisation Council are confidential and I regret, therefore, that I cannot give the right hon. Gentleman the information he requests. As the House knows, Her Majesty's Government supported the United States plan.

Mr. P. Noel-Baker: Since these plans of last June commit both the Soviet Union and the United States to the abolition of all nuclear weapons and the means to deliver them, will the Minister

instruct our delegate in the N.A.T.O. Council to consider the technical means by which these principles can be applied?

Mr. Heath: I will certainly give consideration to the right hon. Gentleman's suggestion.

Oral Answers to Questions — NORTH ATLANTIC TREATY ORGANISATION (SECRETARY-GENERAL)

Mr. Shinwell: asked the Lord Privy Seal when he expects a successor to M. Spaak as the Secretary-General of the North Atlantic Treaty Organisation to be appointed; and whether he will make representations for the appointment of a high-ranking officer of Her Majesty's Forces.

Mr. Heath: Quite soon I hope and we shall do our utmost to secure the best candidate available.

Mr. Shinwell: Without prejudice to my personal views about the future of N.A.T.O., may I ask whether the Minister is aware that the best Secretary-General of the Organisation since the inception of N.A.T.O. was Lord Ismay? Is not it desirable on this occasion, in order to inject rather more effective British control into the political issues involved in the Organisation, that we appoint someone from this country?

Mr. Heath: We would all agree that Lord Ismay was an admirable Secretary-General of N.A.T.O. This matter is now under discussion with our allies. I should not like to comment at this stage on the particular merits of any individual candidate. I think that the right hon. Gentleman would agree that one would not wish to look upon the candidates from the point of view of establishing British control over N.A.T.O. which is, in fact, an alliance.

Mr. Bellenger: Will the right hon. Gentleman look very carefully at the suggestion made by my right hon. Friend the Member for Easington (Mr. Shinwell)? In view of the political issue likely to be involved in N.A.T.O., would not the right hon. Gentleman agree that a general, whether high-ranking or not, is the last person who should be selected for this post?

Oral Answers to Questions — PRIME MINISTER (PROPOSED VISITS)

Mr. Donnelly: asked the Prime Minister if he will make a statement about his proposed trips to the West Indies, the United States of America, Malaya, and Japan.

The Secretary of State for the Home Department (Mr. R. A. Butler): I have been asked to reply.
As has already been announced, my right hon. Friend the Prime Minister has accepted invitations to visit the West Indies and the United States of America during the Easter Recess and hopes to be able in the autumn to take up invitations to visit the Federation of Malaya and Japan.

Mr. Donnelly: Is the Leader of the House aware that the autumn is a long way off? What assurance can he give the House that the right hon. Member for Bromley (Mr. H. Macmillan), at the present rate of progress, will still be "the best Prime Minister we have got" at that time?

Mr. Butler: I think all form indicates that he will be in even better form by the autumn than he is now, and no doubt these visits will be extremely successful.

Oral Answers to Questions — EMPLOYMENT

Commonwealth and Colonial Immigrants

Mr. N. Pannell: asked the Minister of Labour (1) what were the figures for unemployment in respect of Commonwealth and Colonial immigrants in the Midlands area for August, 1960 and December, 1960, respectively; and

(2) what were the unemployment figures in respect of Commonwealth and Colonial immigrants in the London area for August, 1960 and December, 1960. respectively.

The Parliamentary Secretary to the Ministry of Labour (Mr. Peter Thomas): The count of unemployed Commonwealth immigrants is made at quarterly intervals in February, May, August and November. In August, 1960, the totals were 4,667 in London and 1,397 in the Midlands. In November, 1960, they were

6,374 and 2,610, respectively. The figures for the February, 1961, count are not yet available, but I will send them to my hon. Friend as soon as possible.

Cost-of-Living Index

Mr. W. Hamilton: asked the Minister of Labour why National Health and National Insurance contributions are not included as an item taken into account in assessing the cost-of-living index; and whether, in view of the increased and increasing importance of this item in the budgets of millions of people, he will now give it due weight in the index.

Mr. P. Thomas: On the recommendation of the Cost of Living Advisory Committee (Cmd. 9710) these contributions and similar payments were excluded because of the difficulty of measuring the services provided in return. I understand that no satisfactory way of including them could be found.

Mr. Hamilton: Is the Minister aware that the urgency for reconsideration of this matter has been increased by recent developments? Is he aware that, when the new Insurance Scheme comes into operation in April and the new Health Service charges and the consequent contributions are imposed, something like 12s. a week will be taken out of a basic wage very often of £8 a week? That represents a very substantial part of a wage of that kind. Is it not a fact that to suggest that this cannot be incorporated in the cost-of-living index makes nonsense of the index?

Mr. Thomas: As to reconsideration the operation of the index is constantly under review by the Ministry of Labou but, as this item has been considered by the Committee on three different occasions, each with the same result, I see no purpose in asking the Committee to look at it again.

Mr. Lee: Would not the hon. Gentleman agree that my hon. Friend the Member for Fife, West (Mr. W. Hamilton) is on a most important point? Would he agree that especially those in the lower wage brackets will now be asked to pay something which is an appreciable percentage of their income and which in fact is a penal poll tax9 Will he ask his right hon. Friend to agree to submit this item again to the


Cost of Living Advisory Committee in view of the great importance and the great hardship which is involved?

Mr. Thomas: There are many payments such as Income Tax which it has been found could not be included in the index but, as I told the House, the index is constantly under review by my Department.

Mr. J. T. Price: Will the hon. Member explain why it has been found to be impracticable to include a factor for National Insurance contributions in the formula when a factor is included by the mathematicians for domestic insurance, such as industrial injuries, death benefits and so on, paid to private insurance companies? Why can they make an allowance for one item when they miss altogether a much bigger item which has a bigger impact on the wage envelopes of millions of people?

Mr. Thomas: I am afraid that I am not in a position fully to answer that very complicated question, but I can tell the hon. Member that matters such as life insurance premiums are certainly not included in the index.

BAHRAINI PRISONERS (ST. HELENA)

The Lord Privy Seal (Mr. Edward Heath): With your permission, Mr. Speaker, and that of the House, I wish to make a statement about the three Bahraini prisoners detained on St. Helena.
Since I made my statement on 30th January, there have been certain developments.
On 1st February, the Governor of St. Helena received a long letter dated 31st January, the full text of which became available to me only last night, from one of the prisoners, Abdul Rahman al Bakar. In this letter, Abdul Rahman al Bakar informed the Governor that, on 21st January, he had sent a telegram on behalf of all three prisoners to their solicitor telling him that they did not wish him to take any further legal procedings. He expressed surprise that I had not received this information before I made my statement in the House of Commons on 30th January, an account of which he had heard that night in a

B.B.C. Arabic broadcast. He also referred to the fact that on 2nd January, he had told his solicitor on the telephone—and I quote his words:
I prefer to be transferred to Bahrain prison and he [that is, the solicitor] need not to be worried about my position there, which I am quite sure there will not be any danger what-sover to me.
In the letter Abdul Rahman al Bakar then made a strong plea to be transferred to Bahrain prison. Attached to the letter were two messages, one to Her Majesty's Government and the other to the Ruler of Bahrain, which he asked the Governor to forward. He also asked for the Governor's help in getting him moved from St. Helena as soon as possible as a lonely person who had not seen his family for four years.
The message to Her Majesty's Government, after saying that the prisoners' solicitors had been instructed ten days previously to avoid further legal proceedings, appealed for al Bakar's transfer to Bahrain prison immediately.
The message to the Ruler of Bahrain has been passed to him.
It was therefore clear that all three prisoners had requested that no further legal proceedings should be taken in their name. Abdul Rahman al Bakar had also asked that he should be returned to Bahrain, but the views of the other two prisoners in this respect were not stated. The Governor was therefore instructed to interview the other two prisoners in order to ascertain whether they wished to complete their sentences in St. Helena or in Bahrain. This he did on 5th February in the presence of Major Strong, who in 1959 attended as "prisoner's friend" when Abdul Rahman al Bakar applied for a writ of Habeas Corpus. Both replied that if they were not to be released they would prefer to be returned to Bahrain.
I am passing all this information to the solicitors who have been acting for the prisoners.
The next steps to be taken are under consideration.

Mr. Healey: Is the Lord Privy Seal satisfied that this is a voluntary decision by the men concerned, taken in the full knowledge of all the relevant circumstances? If he can give an affirmative answer to that question, I think that all of us on both sides of the House will


welcome the fact that the Government are to be relieved of a repugnant responsibility which, in the view of many of us, they should never have undertaken and which has been profoundly embarrassing to our political position throughout the Middle East. Has he had any reply to the second request which he promised to address to the Ruler of Bahrain that clemency should be granted to these men?

Mr. Heath: I am completely satisfied that the letter from al Bakar is an entirely voluntary document and that it was written as a result of what he heard on the B.B.C. broadcast of the statement which I made to the House. To the best of my knowledge, it was made in the full knowledge of the facts. He has had a full opportunity, by both telephone and telegram, as well as by letter, to be in communication with his solicitor. I thank the hon. Member for his remarks about finding a settlement to this problem. As for his last question, as I have told him previously, that must be a matter entirely for the Ruler of Bahrain.

Mr. Storehouse: Is the Minister aware that his statement is a shocking statement and an unwarranted interference in the relations between three political prisoners and their solicitors? Is he aware that they have had no opportunity of consulting their solicitors about the developments in their case and that they have been subject, as his statement confirms, to psychological intimidation? Will he give an opportunity for the men's solicitors to proceed to St. Helena? As he knows, it is an almost inaccessible island, taking about two weeks to reach. Will he arrange for the solicitors to be granted facilities to visit St. Helena in order that the three political prisoners may have the full opportunity of objective advice?

Mr. Heath: I completely and absolutely reject that statement. When the Government receive messages from the prisoners—which al Bakar had asked the Governor specifically in a letter to forward to them—they are bound to give the utmost consideration to them.

Mr. G. Brown: Whatever the Lord Privy Seal said to the Ruler of Bahrain, will he ask the Ruler whether he is ready to answer the appeal which I certainly made to him to exercise clemency, as I regard four years' imprisonment as more than a just penalty

for the crime which they committed'7 Will he ask the Ruler to let the men out?

Mr. Heath: I recognise the action which the right hon. Gentleman took in his conversations with the Ruler of Bahrain, and I am sure that the Ruler would be prepared to answer any questions which the right hon. Gentleman put to him. I think that the right hon. Gentleman recognises that my conversations with the Ruler must remain confidential.

Mr. Thorpe: Will the Minister say whether the discussions which took place on 2nd January, when al Bakar indicated that he wished transferance, took place between an English solicitor and the convicted men on St. Helena? What were the circumstances in which that discussion took place? Is it not somewhat serious that this firm of solicitors, who were apparently in possession of this information, delayed nearly a month before that information reached the Government, the Governor of St. Helena and the House? Is not this somewhat less than frank on the part of the firm? When the right hon. Gentleman says that the next steps are under consideration, may I ask whether they include a representation to the Ruler that clemency be exercised in this case, as has been happening in other parts of the Middle East recently? Finally, will the right hon. Gentleman bear in mind that this is a precedent which we hope will not be followed by this country becoming a common jailor for other nations and locking up their prisoners?

Mr. Heath: The hon. Member asks about the circumstances of the conversation on 2nd January. I have only the letter from al Bakar to the Governor in which he states that this telephone conversation took place. As it is a matter between the prisoner and his legal adviser, it is not one in which the Governor or the Government have any status whatever. That is why I rejected the accusation of the hon. Member for Wednesbury (Mr. Stonehouse) that there had been any interference of any kind in this confidential relationship.
The hon. Member asks for the reasons why the solicitors have not given us this information. This is a matter for them.


I merely stated the information which we have been given direct from the prisoners. Hon. Members have asked about requests to the Ruler of Bahrain for clemency. As I have informed the House, I discussed this matter with him during the Recess in the light of the debate which had taken place. I think that we should leave it there. Everybody in the House who is anxious that the welfare of these prisoners should be looked after will, I think, take that point of view The future is a matter for events

Sir C. Mott-Radclyffe: In the light of his statement, does my right hon. Friend agree that many allegations made by hon. Members opposite in the debate before Christmas were quite inaccurate and have done quite unnecessary damage to relations between this country and the Ruler of Bahrain?

Mr. E. Fletcher: In view of the confidence which the prisoners apparently have now expressed in the impartiality of the justice of the Ruler of Bahrain, will the Lord Privy Seal give an undertaking to the House that he will repeat to the Ruler of Bahrain the generally felt view that the Ruler should exercise a great measure of clemency in his treatment of these prisoners?

Mr. Heath: I earnestly believe that, if the welfare of these prisoners is to be considered, the matter should be left where I have left it.

Mr. Stonehouse: On a point of order. In view of the wholly unsatisfactory nature of the statement and the misleading information which has been given to the House, I beg to give notice that I shall raise the matter on the earliest possible occasion, either on the Adjournment or on the Consolidated Fund Bill.

LOCAL GOVERNMENT (ALLOWANCES TO MEMBERS)

3.41 p.m.

Mr. G. W. Reynolds: I beg to move,
That leave be given to bring in a Bill to amend section one hundred and thirteen of the Local Government Act, 1948; to provide for the payment of allowances wherever approved duties are performed; and for purposes connected with the matters aforesaid.
The House will remember that in the Local Government Act, 1948, provision was made whereby elected members of local authorities could claim certain expenses and subsistence payments. Two factors have arisen since, one being the fact that for a large number of committees or bodies on which the members serve it is not possible for them to claim expenses because they are not regarded as approved duties. I do not wish in my proposed Bill to make any alterations in those aspects of the problem.

Mr. Speaker: Order. In the interests of the hon. Member for Islington, North (Mr. Reynolds) and of the whole House, can we be a little more silent?

Mr. Reynolds: I was saying, Mr. Speaker, that I have no wish in my Bill to make any alterations in the type of meeting or in the number of bodies to which the provisions of the Local Government Act, 1948, as regards subsistence apply.
What I intend to do is to abolish another obstacle, namely, that members of borough councils and urban district councils cannot claim any travelling expenses for attending meetings of the local authority in the authorities area. At present, particularly in some larger county boroughs, it often happens that members have to pay a 1s. or 1s. 6d. fare in order to attend meetings at the local town hall two or three times a week. Whilst this may be no hardship to some members, it is becoming an ever increasing hardship to old-age pensioners and others on small incomes serving as elected members of local authorities.
There is also the provision at present whereby members of county councils and rural district councils cannot claim travelling expenses or subsistence if the meeting takes place less than three miles


as the crow flies from their home. I seek to abolish this provision also so that it will then be possible for elected members of local authorities to claim fares and subsistence allowances for all approved duties that they attend, no matter whether they are borough or urban district councillors or where the meeting happens to be held in a rural district or in a county council area.
There will be no intention to extend the scope of meetings at which such allowances can be claimed.

Question put and agreed to.

Bill ordered to be brought in by Mr. Reynolds, Mr. McCann, Mr. Cliffe, and Mr. C. Pannell.

LOCAL GOVERNMENT (ALLOWANCES TO MEMBERS)

Bill to amend section one hundred and thirteen of the Local Government Act, 1948; to provide for the payment of allowances wherever approved duties are performed; and for purposes connected with the matters aforesaid, presented accordingly, and read the First time; to be read a Second time upon Friday, 24th February, and to be printed. [Bill 71.]

NATIONAL HEALTH SERVICE

3.44 p.m.

Mr. George Brown: I beg to move,
That this House deplores the statement made by the Minister of Health on 1st February which clearly indicates the determination of Her Majesty's Government to undermine the National Health Service and to place heavy burdens on those least able to bear them.
In speaking to this Motion, I shall inevitably be dealing to a large extent with arguments about money and economics. I want to put the Minister's own case under the light and under the glass. To do that I must to some extent deal in his currency.
At the very beginning, I should like the House to recall, as I am sure it does, that the debate is really about people and how they live. Shall the citizens of tomorrow be helped to get off to a good start today with welfare foods made so easily available that every encouragement to use them exists? Shall the sick—all of them—be treated to one standard, the best available? Shall their treatment, cure and general care be a charge on all of us who are healthy? We should remember that we are all liable to be sick or old or both; unless we are especially lucky or especially unlucky, we shall all at some time be in one or other of those classes.
Lastly, the debate is about whether the cost of doing this shall be borne by each of us according to our general ability to pay, just as our receipt of care when we need it shall be assessed by our general needs at that time.
That is what the debate is about. As I shall hope to show, there is a great, fundamental and deep gulf between right hon. and hon. Gentlemen opposite and my hon. Friends and I on this issue. Speaking without too much emotion, I hope and without what I am sometimes accused of, namely, too much vigour at this Box, I believe that the policy we seek to censure today is indeed a monstrous one. It is a monstrous policy which has offended many far beyond the ranks of those who normally support my party. Hardly a newspaper, however sycophantic, however willing normally to find a case for the Tory Party, has been ready to support this policy fully.
The Sunday Times, on 5th February, contained a leader which I want to quote. I select this from the many possible leaders I could quote. It started with friendly words to the Minister and ended, as one would expect, with friendly words to the Minister. It also contained the words:
But Conservatives should beware of thinking that a principle has been affirmed to which modern Toryism can nail its colours; for no new principle has been introduced. A permanent principle cannot be manufactured out of a moving percentage, and in so far as the reforms are to be judged in terms of principle they are far from invulnerable.
That goes a long way for the Sunday Times.
The leader continues:
If the problem is looked at purely as one of raising the £850 million cost of the Health Service, and the different sources as taxation or pseudo-taxation under various guises, it is not good in principle to off-load from a graduated Income Tax, or from duties on consumption goods, to a poll tax on the gainfully occupied … or to a levy on the sick (as the extra charge for prescriptions can be made out to be).
In addition to what the newspapers have had to say about it, we have all been inundated with letters from all kinds of people. We have had thousands. I have had a larger post bag on this than on anything since Suez. Of all the letters I could quote—I could quote many; they are all here—I wish to quote one which came not to me but to my right hon. Friend the Leader of the Opposition. It is a two-page letter. The Minister may have it to look at. Whoever is to wind up tonight may have it for his winding-up speech. I will read only the first and last paragraphs:
Dear Mr. Gaitskell,
Increased charges for medicines in the State service. My background is a doctor of 68, practised medicine for 43 years, chiefly as a panel doctor, but the last three years as a consultant. I am a lifelong Conservative. I am horrified and amazed by my Party's proposal to prostitute the whole principle of a State service and to render that service a hardship to poor people who need it most of all.
He goes on for two pages explaining why he feels that, and winds up—a life-long Conservative and all his adult fife a doctor:
After a lifetime of helping others and healing the sick, my considered opinion is that anybody supporting the increased charges is a wicked old"—

Here, I am afraid, I am in some difficulty. I think that the word he meant to type was "beggar", but that is not, in fact, the word that he has typed. I was happy to see that the doctor also wrote a letter to the Daily Telegraph; not in quite the same terms, but saying the same thing.
That letter is similar to many that we have had from pharmacists as well as from doctors, from patients and from the dependants and supporters of patients. If the Minister is not moved, as we must be moved by some of these letters, he must be a very hard man, indeed.
The real trouble is, if I may use some terminology that comes easily to me from old Ministry of Works days and, further back, to building days—that we have here a noble edifice that requires a great and imaginative architect for its improvement and for its continuation. Instead of a great and imaginative architect, we have a quantity surveyor. That is our trouble. We have descended from the real problems to fiddling about and messing about with quantities and bills of costs.
Let me on behalf of this side nail up our colours. We believe that a comprehensive medical service, free to the patient at the point of need and with one standard for all the sick, was good and is good, was attainable and is attainable, and we remain for it. The Tories never were for it. If the Minister has one advantage to commend him over his colleagues it is that he has never failed publicly to act as they believed. When the Service was introduced, and when the Bill was going through this House they opposed it at every single stage. I believe that it was the only great social service of the Welfare State that they opposed on Third Reading.
I recall the issue of the document called One Nation, of which the Minister, together with that modern progressive, the Colonial Secretary, together with the Lord Privy Seal, together with the Leader of the House, were the great authors. I have re-read it for this debate. I have never in my life read such loving nostalgia for everything to do with charity and the Poor Law for the wretched in our country. They recite the lot. They go back to Edward's Statute of Labourers, they come up through the Elizabethan Poor Law, they extol the virtues of giving alms to the poor and, of course, they end with the declaration,


from which the Minister has never departed, that, when they had the power, charges would be imposed.
Indeed, One Nation went further—and it may be that this is the next move that hon. Members opposite will be asked supinely to support. It called for charges" for board in hospitals. In April 1958, and in November, 1959, the Minister himself canvassed the abolition of all subsidies on social services, and particularly the subsidies on housing. I hardly need to read quotations—I do not think that the Minister will dispute them. On housing, he made a declaration that
The council house system today is morally and socially damaging"—

Hon. Members: Oh.

Mr. Brown: Today we should debate honestly and openly and devoid of any cheats in this House. There are many people who feel that we—

Mr. Victor Goodhew (St. Albans): Would the right hon. Gentleman tell the House whether he really believes that the council house system as applied today results in a fair distribution of public money?

Mr. Brown: For the moment, I am dealing with what hon. Members on both sides—[HON. MEMBERS: "Answer."] The jackals bay when there is nothing better they can do. The issue at this moment is that the Government, the party in power, should answer for their declarations.
The Minister said:
The council house system today is morally and socially damaging, and I think we might do something about this nuisance during the life of this Parliament.
Let us have it on the record for April—

Mr. Goodhew: The right hon. Gentleman surely knows my views on this. I made it quite clear that I considered that this was something that should be dealt with by the House, and I blame his party in various parts of the country for not doing something themselves.

Mr. Brown: That is a really good dodge, but the hon. Gentleman will notice that the Minister does not do that. That is what I said about the right hon. Gentleman—that is the sort of dodge the Minister does not use. He does believe that that system is morally and socially

damaging. He does believe that it is a nuisance. He does believe that we should abolish the council house subsidy—

Mr. Goodhew: So do I.

Mr. Brown: I am glad that the hon. Gentleman says that, but I do not think that his belief adds much to the debate.
Further, the Minister really does believe that
Given that redistribution is a characteristic of the social services, the general presumption must be that they will be rendered only on evidence of need….
The question that therefore poses itself is not whether a means test should be applied to social services, but whether any social services should be provided without a test of need.
That is the fundamental difference between us. What I want to get clearly accepted is that the Tory conception of social services in general, of our duty, as a community, to each other, is wholly different from ours. They will provide an ambulance service for the wretched—we do not dispute that. The Minister will provide that, but it will be an ambulance that will not be too comfortable and not too easy to get lest the chap who gets it might be lazy and might thumb a ride when he should walk. That is the real point. The service will be there for the absolutely wretched—for the fellow who really falls right through—but it will not be there just because we ought to take care of the men and the women who have need and whom we ought to help.
We, on the contrary, applaud the element of redistribution involved by this and other social service schemes. We believe in a society in which we would be members, one of another, whose duty it was to share each other's burdens. We did and we do mean a comprehensive National Health Service to be a permanent feature of our life.
What is the Minister's case? On what grounds does he claim that it is right to do this? There were two statements, and I will take, first of all, the one made recently when these charges were introduced. He said three things, and I will come back to an earlier one later on. The first is that the cost of the Service is getting too high and that we cannot


afford it as a nation. The second is that, unless it is cut, desirable developments in the Service—in particular, new hospitals and such—cannot proceed. The third is that there is waste in the Service which the charges will help to avoid. Those are the three legs on which he stood, and I will deal with each in turn.
Firstly, I will deal with two arguments which are not really relevant but which have been very heavily overworked by the party opposite. The first was overworked by the present Minister in 1957 when as a junior Treasury Minister he introduced the separate health contribution and doubled the existing figure. I answer it now because he may have intended to make the same case again. The burden of his case then was an inherent conception from the beginning that 25 per cent. of the cost should be found from contributions. He worked that very hard over many pages in here. The second of these irrelevant but hardworked arguments is that Labour did something like this in 1950–51. I have no doubt that we shall hear a good deal of that argument again today.
I will deal, therefore, with both of those arguments before I deal with the main one. The 25 per cent. conception of the Minister rests on the fact that during the war the Actuary's memorandum attached to the Beveridge Report included the figure of 10d. as the contribution which was assumed to be available for the health provisions. That 10d. was assumed to bring in £40 million, and the total cost of the Service was estimated to be £170 million. The figure of £40 million is roughly a quarter of £170 million, and so, Q.E.D., it was an inherent conception, the Minister said in 1957, which was embodied in the Bill, that a quarter of the cost should be covered by contributions. I have read everything carefully once again, and there is absolutely no foundation for that at all. The 10d. arose quite arbitrarily. It arose only in the Actuary's memorandum The only reference to it is that it is the sum available for health. It is not that it is the sum chosen for health, and not the sum we have to have in order to get that proportion for contributions. The only reference to it in paragraph 34, and again later on, is to the effect that that is the sum available.
In any case, the actual cost of the scheme was so wildly different from the Actuary's guess that in any case the 25 per cent. notional relationship or coincidental relationship was completely destroyed at the very beginning. Nobody ever proposed that the 10d. should be doubled, trebled or quadrupled to get back to the notional relationship of 25 per cent. That argument, on which he rested his whole speech in 1957—perhaps he is hoping to use it again today—is just an alibi, a rationale thought up after the event. It has no historical validity at all. In it we see the politician in the right hon. Gentleman and not the teacher.
Turning to the second argument, every time Health Service or prescription charges come up in the House reference is made to Labour's action in 1950 and 1951. The allegations are that we imposed a ceiling and we imposed charges. As a matter of detail, we did not impose charges. We introduced an enabling Bill under which the Tory Minister imposed charges. I do not make a lot of that. [Laughter.] There is a certain usefulness in getting the facts right, is there not? I imagine that if the Tories are to defend an issue such as this, probably one thing they will not wants to do is to get the facts right.
I do not rest my case on that. I want the House to be clear about the times in which we were then living. I will let the House into a personal secret. When I sat on this Bench today I felt it very deeply, when I heard my hon. Friend the Member for Nelson and Colne (Mr. S. Silverman) and other hon. Friends saying things about defence policy with which I disagree and on which I took a position near to the Minister of Defence, and I felt bound in all honesty to show that I disagreed. I did not think it would be honest not to. As I was doing that I suddenly thought, "Gracious, in a minute we shall argue about the Health Service charges. We had to do some things in 1950, because of the Korean war, on which the party opposite supported us. Will they be so honest today as to say that we were then under financial strain and not use the consequences against us for political advantages?" I restrained myself from getting up, as I was tempted to do, to support the Minister, but I knew jolly


well that ever since the Korean war, on which they said they supported the Minister of Defence and the Prime Minister, they have never ceased to use the consequences for mean political advantage. I doubt very much whether they will have the guts to do it today.
I go further. The ceiling that we sought to impose in those difficult times—a ceiling which was never held, to get the facts right again—was a higher proportion of the Exchequer expenditure, and a higher proportion of the national income, than they are spending now. It was clearly established in the Budget speech of my right hon. Friend that it was to be regarded as a temporary position relating to circumstances then prevailing and not be regarded as a desirable or permanent thing. The fact that they use what we did, rightly or wrongly, in 1950 at the time of the Korean war as a justification for what they are doing today, is a fearful commentary on the situation where they claim we have never had it so good. We have never had it so good that they make it worse for the sick and needy than we had to make it in 1950.
I turn now to their major case. The first argument is that the cost is too great to be borne. At around £860 million the Minister says that if it goes any higher we would have to stop having desirable things and the figure itself is too high. It is only a little over half what the nation spends on defence. While I defend what has to be spent on defence, I am bound to say that the society we are proposing to defend is an important consideration also.
The total figure or a sum of money by itself is no guide. It has to be looked at as a proportion of the national income. A fixed sum is relevant only by reference to the total from which it comes. As a percentage of the national income, our expenditure on the Health Service rests almost exactly where it was in 1950. For everything that has happened since, for all the things the Government have taken credit for, for all the expansion that they claim to have done, for all the improvements, for all the "never had it so good" wonders of Conservative administration, they are spending no more on health than we were spending in 1950. Indeed, they are spending a little less. In 1950, the percentage of

the national income which went on health was 4· 5. Today, taking current and capital expenditure together, it is about 4· 2, a little less after ten years of alleged Tory progress.
Taking it as a percentage of total Exchequer expenditure, of what the Government spend on our behalf, it has remained steady. It was 10· 6 per cent. in 1950. It was 10· 4 per cent. in the Civil Estimates for this year. It has, in fact, gone to 11· 7 per cent. in the corrected Estimates, but the extra is to pay for the doctors' and dentists' pay and includes a very large non-recurring item on account of back pay. It is, in fact, something less than 11· 7 per cent., and I do not think I am far wrong when I say that it has remained just about the same as a percentage of Exchequer expenditure. The claim, of course, is that it is too high, although it is no higher than it was ten years ago.
I take it next as a percentage of what we find for the social services. It has fallen from first priority to third. It has fallen from 28· 5 per cent. of the social security budget to 23· 1 per cent. On 1st February this year, in the passage to which I have already referred, the Minister, in introducing the charges and referring to the total cost of the Service said that it could not be allowed
to go on increasing at so high a rate".
The fact is that it is not increasing "at so high a rate". Taking 1949 levels of prices and remuneration if we refer to Table 27 on page 57 of the Minister of Health's own report on the costs, in this case, of the National Health Service—we find much the same answer for the rest of the services as the Ministry gave for the Health Service—we find that in real terms the advance in expenditure on this Service over eleven years has been 22 per cent. That is 2 per cent. a year. According to the Minister, we cannot let it go on rising at that rate.
What are we telling our people—that we cannot put 2 per cent. extra a year into the Health Service? Is that too much for us? Is that disaster? If the Minister and his supporters really mean that, they had better go and talk in real terms to their constituents.

Dr. Barnett Srross: Will my right hon. Friend take up also the point that the population has increased considerably?

Mr. Brown: Will my hon. Friend allow me to tell him that there are so many points I could take up that I should be here for the rest of the day? I had better leave a few for him and for others to raise.
When the Minister says that the cost of the Service cannot be
allowed to go on increasing at so high a rate",
what he really means is that we cannot manage 2 per cent. a year for the Health Service. [Interruption.] We may still disagree in the end, but I ask hon. Members opposite to take this seriously. For very many people there is no more important and no more moving subject than what we are now discussing.
They may think that I am wholly wrong, and I may bore hon. and right hon. Members, but I ask them at least to try to listen to the argument. I will do my best not to trespass.
We are spending about 4 per cent. of our national income on health. A revealing comparison can be made in the figures shown in the I.L.O. Report entitled "The Cost of Medical Care", issued in 1959. Unfortunately, the figures relate to 1953, but I shall have a word to say about that in a moment. In 1953, there were only two countries among all those referred to which spent less than we did out of their national income on the care of people who need a Health Service. I am talking about public and private expenditure, the whole lot. The Report produces all the figures and sets them out. Only two, Holland and Denmark, provided less out of their national income than we did.
The matter is worse than that, of course, because we happen to know our figure for 1959. It is still about 4 per cent. Those of us who know the Continent of Europe know very well that the continental countries have moved forward enormously in their social services between 1953 and 1959 and, when the comparison for today comes out, it will look even worse than that table for 1953 revealed. The case the Minister made seems to me to be a silly collection of unsupported allegations and assertions. There are no facts to back up the assertions he has made.
The issue today is as it was in 1946, as it was on the Second Reading of the National Health Service Bill and on the

Third Reading of the Bill—not whether we can have a comprehensive medical service free to the patient at the point of need, but whether we want to have such a comprehensive social service. That question is answered by us "Yes". It is answered by the Minister now, as it was then, "No". The issue is as simple as that.
The Minister's second argument was that we must make the cut and that, if we did not, we could not go on with the development of the hospital service, building new hospitals and so forth. I welcome the new hospital programme. We have called for it often enough and, heaven knows, the Government's record during the ten years they have been in power has been a fairly grim one in hospital building. It is not this Minister's fault. Others here can answer for that.
What does the hospital building programme provide? It provides for an increase of £5 million a year from now until 1965–66. That is what it comes to. The Minister proposes to take back through his charges and contributions £65 million a year. He is not just taking back £5 million for the hospitals. He is taking a cumulative increase, £65 million on top of £65 million every year.
As regards the £5 million for the hospital programme, is it seriously argued by the Minister, who ought to know, that the gross national product will not rise at all in the next five years? Shall we stagnate economically as badly as all that? If so, it is a jolly good job he did not make a speech in the debate yesterday or the day before. However, let us assume for a moment that he is right and that we cannot provide the hospitals if we do not take charges from the other part of the Service. What is the next step?
In one of the Conservative Party documents, we are told that we cannot build the extra universities and provide the extra university places unless fees are charged for secondary grammar school education. Is this the next move? It is an extension of the same principle. If we cannot build hospitals unless we increase charges for prescriptions, for welfare foods and so on, the same argument can be made for charging for education so that we may provide the extra university places.
The whole thing is childish, dangerously childish. It shows what can happen to a great concept, to a great and extremely important part of life, when, as the late Aneurin Bevan once said, little men do silly little sums. These are the consequences of having a former junior Treasury Minister where an imaginative senior Minister ought to be. This is the problem.
The right hon. Gentleman's third argument is that these proposals are needed to prevent waste. But how will that be achieved? Presumably the waste to which he refers is the drug bill, and that is why he is increasing the prescription charges. In this, past experience and, as far as I can find, all advice are against him. The Hinchliffe Committee, the Lancet, economists who made an investigation and even the men who helped to invent the original prescription charges scheme were all against him. They found that the effect of the previous scheme was not to prevent waste but to encourage it because people tried to help each other out and doctors tried to help poor patients by prescribing for them things which they should not have prescribed.
When the right hon. and learned Member for Hertfordshire, East (Sir D. Walker-Smith) was Minister, he was strongly pressed about the Hinchliffe Report on 15th July, 1959. In paragraph 301 of the Report, it was said that it was hoped that this would lead to the abolition of the charge and not an increase in it. The right hon. and learned Gentleman said:
If such a scheme proves successful in controlling expenditure on drugs, we would, naturally, consider whether the saving justified the abolition of the prescription charge at the end of the two-year period as suggested … "—[OFFICIAL REPORT, 15th July, 1959; Vol. 609, c. 440.]
We are not yet at the end of the two-year prescribing period, yet the Minister is putting prescriptions up. The right hon. and learned Member for Hertfordshire, East, knew that this was the way not to cut but to increase waste. The Minister is going against all advice. Indeed, the whole weight of opinion, both medical and lay, is against him on this.
What is the waste? We must be careful about this. It is not necessarily in the number of people to whom drugs are supplied or in the number of prescriptions for drugs. There has been a great

advance in new and expensive drugs, specially in antibiotics, in recent years. These drugs do save lives. Killer diseases are coming under control. People are getting back on their feet and back to work very much more quickly. Of course, these drugs cost money. I will come in a moment to where I think the waste is, but do not let us get into a state of mind where the fact that more expensive drugs are being prescribed by doctors for sick patients is in itself a bad thing. If we do, we shall end by believing that the invention of penicillin was a disaster for the world when, of course, the contrary is the case. Let us applaud it, not nag about it.
Let us put it at is worst. We still lose 75 times as many work days because of medical incapacity as we lose by industrial conflict. In 1957–58 we lost 300 million days. Even if it is put at is worst, it is still a good and useful expenditure of money to avoid that to say nothing about the human aspect. I should like to paraphrase a poster which we used to see on the hoardings before Tommy Trinder became chairman of Fulham Football Club, which, speaking as a supporter of West Ham United, is a fate almost worse than death. The poster said, in effect, "If it is waste you are after, do not go to the patient". It is not the patient who is wasting the money. He has had the misfortune to become sick. I say that if it is waste the Government are after they should go for the manufacturers and for the industry. There is no doubt that it is the state of the pharmaceutical industry at which we ought to look.
May I give some reasons for saying that? There is a fearful waste in sales promotion and sales pressure. I shall be very surprised if doctors and chemists have sent me letters but not to anyone else about this. I have the most incredible collection of evidence here which has been sent to me by people I have never met and who, I am sure, have never voted Labour about the free gifts which pour through the doors of doctors from pharmaceutical firms. A torrent of unsolicited stuff is poured through doctors' letter boxes. I have estimates of the cost of this. They are enormous. No one believes that these firms are giving away the full value of what they are making


and selling. I have much evidence about dubious sales methods. Incidentally, the Minister could "have a go" himself if he would get at the hospital management committees about the degree of by-passing of their central arrangement which is going on through pressure being put by salesmen on matrons and other hospital officials to get them to buy things. In this way they by-pass the central purchasing arrangements of the hospital management committees.
The right hon. Gentleman might have a look at the maintenance of prices and the ring arrangements in the industry. Again, I am speaking about what he can do himself if he wants to tackle the problem of waste and not take it out of the patients. Why does he refuse to allow the hospital management committees to take advantage of the patent law restrictions which are available to all other Crown services? Why does he not insist that they should be available to them as well, since he himself said that they were legally entitled to do them in answer to a Question the other day? Why does not he look into—or get someone to look into it for him—the reason for the maintenance of the higher proportion of sales of proprietary drugs against a generic alternative when a generic alternative exists? I have examples of enormous differences in price, four, five, eight and nine times the difference, between the proprietary article and the other.
The Minister might also look at the absolutely indefensible rise in profits in this industry. I have seen examples of the rising profits of various firms of anything from 80 to 400 per cent. over the last eight years. American subsidiary firms have been making profits of more than 100 per cent. per year on the total capital involved. All kinds of bodies and public servants, including the Comptroller and Auditor General and the Public Accounts Committee, and I do not know who else, have reported on this matter.
I am bound to ask what it is that the Minister is afraid of, like all his predecessors. This perhaps will sound offensive, but I deliberately mean what I say. The Minister finds it easier to take it out of mothers, their children and the sick than to take on this vast great industry. Let us have a full inquiry

into the cost of drugs and into the state of the pharmaceutical industry. Let us look, without any commitments to begin with, at this dragon of uncontrolled private enterprise waxing fat at the public expense and be prepared to take State action, whatever it involves, and not be afraid for doctrinaire reasons.
The hon. Member for Torrington (Mr. P. Browne) has declared himself on this matter. He is wide awake, alert and alive to what is involved. He said that the time has come to consider the nationalisation of the drug firms, many of which are American-owned. I am, of course, not so committed. All I ask is that there should be an inquiry. Let us get at the facts. The hon. Member for Torrington may turn out to be right after we have had the inquiry. If the Government do not do that, if they will not get at the facts, for heaven's sake let the Minister and his hon. Friends stop making indignant noises about the depredations of the burglar and then quieting their conscience by taking it out of the victim's sick children and the victim's sick parents.
Incidentally, I address this specific question to the Minister in the light of what he is proposing to do. Will he give us a pledge today about the question of drugs for private patients outside the Health Service? A hundred or so of his hon. Friends do not seem nearly as concerned about the cost or about the waste as the Minister says he is. They are prepared to widen it much further by introducing a second tier, a new stage. It could easily be the next move. Will the Minister give us this pledge? I ask him for it. We are entitled to have it.
In my summing up, in which I hope I have carried the House with me, there is absolutely nothing in the case that the Minister has made for the actions he proposes to take. The excuses he has given could not be flimsier. He does this because he believes in it. He does not do it reluctantly because things are in trouble. He does it because it is part of his basic philosophy. Those who vote with him tonight accept and vote for his basic philosophy. They cannot then make speeches in their constituencies saying that they are also for the Welfare State and for the National Health Service.

Mr. James Dance: I am prepared to make a speech in my constituency on a reasonably healthy Welfare State which is economically sound.

Mr. Brown: I am sure that, whatever Welfare State the hon. Member spoke for, he would be heavily qualified about it. I am quite prepared to go into any of the constituencies of hon. Members opposite, with any one of them, and discuss this issue with their constituents. Hon. Members opposite raised the charges. They imposed the higher contributions for one reason only. They want to redistribute wealth to the greater advantage of the better off at the expense of the poor people and those in trouble.
Let me show evidence for that. I cannot take into account what the Chancellor proposes to do in April, although I could make a fairly good guess about what he will do. Let me show some evidence by looking backwards. Let us consider, if hon. Members opposite will, the miserable £16 million which the Minister is taking out of the welfare foods and all the other charges which he is imposing on the people who are in need—otherwise they would not be asking for these services—and compare that with the recipients of past largesse from Chancellors of the Exchequer on the benches opposite.
The party opposite always, does this outside the Budget, and this is why. We now have two Budgets every year. We have one in which the Government tax the poor and the sick, as they are doing now, and we have another one in April, when they give the proceeds away to their pals and to the better-off. Take the dearer welfare foods, the extra cost of orange juice and cod liver oil, and compare that with the cheaper alcohol drinks that the Government arranged last year and years before. Under a Tory Government, it is cheaper to drink wine but more expensive for the children to drink orange juice—£4 million tax relief on wines and £1½ million tax increase on orange juice and cod liver oil. Compare the charges on spectacles and teeth—about another £1½ million, I should think—with the give-away on gifts inter vivos from death duties and the give-away on directors' remuneration and persuade anybody which of those claimants is the more entitled. Above all, compare them all with the tax-free capital gains that the Government never touch.
Let us look at this in a little greater detail. Let us go back to welfare foods. Think of the proud boast we have until now been able to make about the condition of British children. Their condition owes a great deal to the welfare food scheme and attention to their health. We could say that we maintained it in war. We maintained it in the difficult conditions after the war. The only conditions in which we cannot maintain it are those of Tory affluence. It is no use the hon. and learned Member for Surrey, East (Mr. Doughty) laughing. It is so. We did it during the war and after the war. The only time when we cannot permit children to have orange juice and cod liver oil as a welfare food without charging them the economic price is when, according to the Tories, we have never had it so good.
This is preventive medicine. The Minister makes so much about waste. If he wants to avoid waste, a sensible way is to have some preventive medicine so that people do not get rickets and so that kids do not grow up spindly and so that they grow up strong and healthy. Now. we are taking these things out of their reach. Previous Ministers disturbed the arrangements and the centres from which the welfare food was obtained and the result is that the proportion of people taking it already has fallen catastrophically. The Government now put a charge of 1s. 6d. where formerly there was 5d., and 6d. where there was no charge, and they are discouraging people still further. The Minister knows it, and he means it. This is what he likes to do.

Dr. Donald Johnson: May I take up the right hon. Gentleman's challenge? Will he come to my constituency to debate welfare foods?

Mr. Brown: No comment about that. Is it Brighton? [Interruption.] I am sorry. I got my Johnsons mixed up. I was thinking of the Johnsons whom the Conservative Party heaved out. I am sorry, I got the wrong Johnson. However, I will be in Carlisle just the same. [Interruption.] It is extraordinarily interesting and significant how much fun hon. Members opposite have to get out of the smallest thing that is quite irrelevant to the argument. They must be in trouble.
Let me now turn to the prescription charges, at the raising, the doubling, of


prescription charges. This is providing a positive deterrent to those seeking treatment. This will deter people from going to the doctor. This will encourage them to try self medication. The intention is to get them to go to the chemist and buy something for themselves rather than go to the doctor and get a prescription from him. It also helps another collection of pals: it helps all those chaps on television who night after night are coming forward with their specious advertisements for the very things the Minister says are causing waste. It is a penalty on those who are chemically sick.
I shall listen with interest to as much as I can of the debate, but I have other commitments to go to. [Interruption.] This is ridiculous, this laughter. One does what one can. It is ridiculous that when one makes an excuse sincerely meant it gets that kind of silly laughter. I shall be in the House as long as I can be here; but in case I should miss anybody's speech I was apologising in advance. It will be only at the time of another commitment I have elsewhere That is all. That is all I meant. Surely it is nothing to cause people to laugh like that.
Have hon. Members opposite received the kind of letters which we have receivef—[HON. MEMBERS: "No."]—from diabetics? The hon. Gentleman who is putting his hand to his ear, does he think it wasteful—

Mr. Grant-Ferris: Mr. Grant-Ferris (Nantwich) rose —

Mr. Brown: I will give way in a minute. Let me finish and then I will give way. Has the hon. Gentleman had any letter from a diabetic who has to attend a doctor regularly and have a whole series of prescriptions? Has he had any letters from rheumatic patients who have to see a doctor regularly and have a whole series of prescriptions? Has he had any letter from anybody like a member of my family with a skin disease which needs three or four prescriptions every time she goes to the doctor? She will now be paying 10s. every other week under this new freedom. Has he had any letters like that?

Mr. Grant-Ferris: To be perfectly honest, I have not had any such letters at all. [HON. MEMBERS: "Oh."] It is

absolutely true. It may be that we have a much healthier climate in the Nantwich constituency. But, quite apart from that, Mr. Deputy-Speaker, is it in order for the right hon. Gentleman to speak to an hon. Member in the tones and the manner that he did?

Hon. Members: Sit down.

Mr. Deputy Speaker (Sir Gordon Touche): I am afraid I cannot hear the hon. Member.

Mr. Brown: If the hon. Gentleman has not had any letters, I am surprised, for pretty well all of us have had them. But let us see, since people on the Conservative side are shaking their heads on the point. Perhaps the explanation is in one of the letters I have here, from a chap who says, "It is no use writing to my Member. He is a Conservative."
This is a penalty on everybody with a family. In a family of two or three children, one of them or all of them may be sick and need a prescription. Of course, up goes the bill and that deters a man from getting a prescription. This is a penalty on all small incomes, those for whom the N.A.B. may not be available whose incomes are still very small. This means 2s. an item. We are not talking about a bob or two bob. We are talking about 6s., 8s. or 10s. a prescription. We are talking about people who go every week, certainly every other week, to the doctor. This has become a major attempt to dismantle the comprehensive Health Service.
Let me turn now for a minute to the question of contributions. This is a straight transfer of taxation, away from the principle of ability to pay, towards a £50 million poll tax imposed regardless of financial position. The Minister can check my figures. For the employed person, this doubling of the charge means a 260 per cent. increase in ten years. In that time wages increased by 74 per cent. The insurance contribution which the insured worker pays at present—for heaven's sake let us get this understood—will go up—with wage claims in six months' time. I am glad that the Chancellor of the Exchequer is listening. For the insured worker it means an increase of 6 per cent. at £9 per week and 58 per cent. at £15 per week over what he presently pays, and since the Ministry


of Labour tells us that the average earnings are something over £14 a week, it means for the great majority of employed workers in this country that they are faced with more than a 50 per cent. increase in stamp contributions which they now have to pay.
We hear a lot about the way the Government have relieved people from Income Tax in ten years. Let us just look at this. Let us take a man with £10. There are lots of him. There are far more of him than we are apt to hear about. In 1951 he was still paying Income Tax. With his Income Tax and National Health stamp combined he paid 10s. 1d. a week. Under the Tories, it is true, he has been relieved of Income Tax. They take a lot of credit for this. In consequence of this increase, he is now going to pay 10s. 7d. a week on stamp alone. So he is out of Income Tax and pays 6d. more per week than he did on the combined ticket. But a man with £5,000 a year is more than £700 a year better off than he was ten years ago. Sixpence a week worse off on £10; £700 a year better off on £5.000 a year.
Put it another way. Yield from taxation which comes by way of stamps is up in real terms by 90 per cent. in the ten years. Taxation which comes by way of Income Tax, Surtax and Profits Tax is up in the same period by only 12 per cent.
This is real regression. This is transferring the burden with a real vengeance. This a real demonstration of Tory philosophy. I think it adds up to two things. The scheme is not only no longer free at the point of need; it is now, or will be when the Minister has done his work, a real in-built deterrent. Secondly, it is no longer financed on the basis of ability to pay. It now carries a whacking great poll tax, and the contribution of the Exchequer is down from 80 per cent. where it was when it began to 70 per cent. which is where it will be in 1961–62.
My last words to the House are these. It is no use pretending that we are not bitter about this. We are. I shall not go over my background again—but for any of us who grew up in circumstances where reliance upon a public health provision was essential, the old infirmary and panel doctor system burned itself into our hearts in letters of fire which really moved and shook us. We cherished and

meant the ideal of replacing the old infirmary approach and the old panel doctor approach. Sometimes, on other issues, as I said earlier, I have come to similar conclusions on the facts presented as the Government. Some people, whose political thought is superficial, have sometimes said and written that this meant that the issues between the two parties were narrowing or disappearing. I never believed that. This Minister, supported by the whole Cabinet, as he at the moment is, supported by the whole Tory Party, as tonight, I imagine, he will be, proves that that is not so. Our fundamental philosophies are poles apart.
I could never be associated with an outlook such as he discloses in these proposals. I hope he will not mind my saying that to do so one has to be capable of writing things like the couplet which the Daily Mail quoted on 6th October last year from his own "First Poems: 50 short lyrics". The couplet was:
I hate the ugly: hate the old.
I hate the lame and weak.
I am proud to move this censure Motion.

4.50 p.m.

The Minister of Health (Mr. Enoch Powell): Before I reply to the Motion which the right hon. Member for Belper (Mr. G. Brown) has moved, perhaps I might be allowed to congratulate the hon. Member for St. Pancras, North (Mr. K. Robinson) on his accession to his shadow office. He will, I know, be a very agreeable sparring partner, not least because of his very real interest and concern in the National Health Service and—if I may say so on a personal note—the fact that he shares with me a special concern for the mental side of the Service.
The Motion conveys two charges against the Government. The first is a reference—and I quote from it—to
… the determination of Her Majesty's Government to undermine the National Health Service … 
It will, therefore, be necessary for me to trouble the House with something about the recent development and the future prospects of the National Health Service. Opportunities of talking about the National Health Service do not come so thick and fast in this House that any


Minister of Health can be expected to avoid the chance of taking them.
May I first begin this review with the hospital service? It is not only by far the largest single element in the National Health Service but is, in a sense, the key to the whole, in that the development and integration of the whole crystallises round the development of the hospital service.
I want to refer first to the most essential part of the hospital service, as indeed of any medical service—the human element. The last few years have seen a steady and, in some respects, a quite dramatic increase in the staffing of the hospital service. Hospital doctors in post have increased in the last five years by some 10 per cent., full-time nurses by some 13 per cent., and part-time nurses by 35 per cent.
It is, no doubt, due to this large strengthening in the staffing of the hospital service that we have been able to achieve in it the striking increases in treatment given, to which I referred in the House last week: an increase in inpatient treatment of 10 per cent., in out-patient treatment of 5 per cent., and in domiciliary consultations of over one-third.
We have, in fact, been able, because of this steady strengthening of the personnel element of the hospital service, to make a more intensive use of the physical facilities which were available. Much still remains to be done. We need a considerable strengthening, particularly, of the medical auxiliaries—and here it is very encouraging to notice the large increase in the number of students in medical specialities which will, inevitably, in a few year's time, enable us to make good many of the existing deficiencies.
The Working Party under Sir Robert Platt, which has been studying the medical staffing of the hospital service, has just presented a very important report. This will be published next month, and my right hon. Friend the Secretary of State for Scotland and I will immediately engage in consultations with the professions upon the recommendations of that report.
I should also like to refer, while I am on the matter of personnel in the

hospital service, to the strength of the midwifery element. This is at present severely undermanned—perhaps I should say "underwomanned". I have just asked the hospital authorities to take a number of specific steps, and, if possible to take them urgently, which will render midwifery more attractive and which will enable them to retain or attract back into the service the women whom we need. These are directions in which we want to go, and go faster, in strengthening the staffing of the hospital service.
The reference to midwifery leads me to another aspect of the hospital service which, I believe, has been unduly neglected while other sides have been developed. This is the human side, the relationship between hospital and patient; the attitude of the hospital service to the individual man and woman in its care as a human being and not merely as a case.
I believe that in this respect some parts, at any rate, of the hospital service have been out of step with its general development. The Central Health Services Council—[Interruption.] I am sorry if Members opposite, who have put down a Motion of censure do not want to hear about the National Health Service and its development—

Mr. William Ross: We can discuss this on Scottish estimates at any time.

Mr. Powell: The Central Health Services Council has just made three remarkable reports on three aspects of this human side of the hospital service. One is on the care of women in childbirth, another is on the in-patient's day, and the third is on noise in hospitals. On all these matters, and on the whole approach of the hospital service to the patients, I believe that progress needs to be made, and I should like to see 1961 as a year in which there is a marked change and progress in this respect.
All these things on which I have been speaking can be, and to a very large extent have been, achieved in the existing buildings of the hospital service, but there can be no dispute about our need to modernise the buildings, and, indeed, to modernise the whole pattern of the hospitals in this country.
In recent years, capital outlay upon the hospitals has been rising rapidly from under £10 million a year, five years ago, to £25 million in the current year and, with increases intended, to £31 million and £36 million in the two coming financial years. But this year we opened a new phase in the history of the hospital service by asking hospital authorities throughout the country for the first time to take a ten-year view of commencements and a fifteen-year view of building work which they wish to see carried out.
For the first time the hospital service in this country is being asked and is being enabled to plan ahead on a rational basis, with the full view of ten or fifteen years' work. For the middle of the decade the basis has been taken of some £50 million annual expenditure upon capital account, but beyond the middle of the decade the Government have placed no financial limitation on the plans which they expect the hospital authorities to put forward. They are being asked to set out what they believe would be the practicable and desirable development of the hospital services in their regions over the next ten to fifteen years.
Here is the truest economy, for by these means we shall be able to ensure that the temporary work, the work on improvement, the work on expansion which we do, is logically built into a long-term plan. We shall be able to see that the short-term planning is of the right amount in the light of what we intend to do about the longer term, and by means of this long-term plan we shall achieve the utmost return from the capital expenditure which we incur year by year.
But it will be not only on capital account that we shall by this means achieve true economy. The hospital authorities are to reflect their capital plans in terms of running costs, and so for the first time we shall be able to see how the modernisation of the hospital service should reflect itself in genuine economy in the running costs of the hospitals, which are the main element in the cost of the National Health Service.
In this immense operation the cooperation will be needed not only of the

hospital authorities, but of the public at large and of Parliament. We are facing a period in which the pattern of the hospital service in this country, if it is to be modernised, will in some respects have to be radically altered. That radical alteration and modernisation will mean the giving up of many old habits, the loss of many old associations, and the Government will need the support of Parliament and the public in carrying through this wholesale alteration and modernisation of the pattern over the coming decade and decade and a half which is undoubtedly necessary.
But this prospect of being able with security and with sureness to look forward to development in terms of decades has already in my experience revolutionised the morale of the hospital service. There is already an immense surge of confidence and a forward-looking attitude. [HON. MEMBERS: "Where?"] I advise hon. Members to ask any hospital management committee, or any hospital board, which is concerned in this work whether this is not the most inspiring task upon which it has been engaged since the hospital service began.

Mr. Edward Gardner: Will my right hon. Friend allow me to suggest that some of the people who might be asked whether they are stimulated and inspired by his programme are those of Basildon New Town, where a new hospital is about to be built?

Mr. Powell: The modernisation of the hospital service will not and cannot stand alone. We cannot have a modern hospital service unless the local health services are also expanded and modernised. One of the ways in which the new hospital plan will be an instrument of progress is that it is bound to spell out the directions in which the local health and welfare services must be expanded in order to support the hospital service.
We must have local health and welfare services which will ensure that we use the hospitals for the purposes for which they are suitable, that we can use them intensively, that we can use them properly and that we can give care outside the hospitals and in the community in all the various situations which are appropriate to those who do not need hospital care.
I often think that the local authority element of the National Health Service is unduly overlooked and disregarded. In present terms of magnitude it is by no means negligible. This year, the current expenditure of these authorities amounts to another £100 million on top of the £860 million or £870 million of the National Health Service in the narrower sense. If the local authority services are to expand and be modernised along with the expansion and modernisation of the hospital service, two great elements will be necessary. The first will be in capital and the second will be in personnel.
There has been more capital development here in recent years than is sometimes realised. The number of places in old people's homes in the last five years has gone up by 20 per cent. The number of places in training centres for the mentally sub-normal has gone up by 50 per cent. Those rates are still rapidly rising. Capital expenditure has trebled in the last five years and this year is nearly £13 million, or approximately half the capital expenditure in the hospital service itself, and I expect that loan sanctions in the coming financial year will amount to £20 million.

Mr. Emrys Hughes: What about the rate of interest?

Mr. Powell: Local health and welfare authorities are being asked to regard this as the level at which their capital investment should continue.
This capital investment, the building and creation of the institutions which the local health and welfare authorities will need, is an integral part of the growth of the local health services by the side of the hospital service; but even more so is the development of the right numbers and the right kind of personnel in the local authority services.
In my contacts with the local authority services I have been immensely impressed by the work which has been done and the calibre of the people doing it in the domiciliary services. It is a tremendous experience to realise how much can be done for the family and for an invalid still living in his own home, by the domiciliary officers of a local authority. This is a side of the services which calls for expansion and strengthening in personnel.
There are two recent important reports on two important elements in this personnel side of the services—the Jameson Report on Health Visitors and the Younghusband Report on Social Workers.

Mr. Percy Collick: What is the debate about?

Mr. Powell: The debate is about the National Health Service. The debate is about a Service which the Motion says Her Majesty's Government are determined to undermine.
The Government have already announced their acceptance of the main recommendations of the Younghusband Report. One of the most important of those is the establishment of linked national councils for the training of health visitors and social workers. The person who is to be chairman of these linked councils will be a key figure in the development of the local health services, and I am delighted to be able to tell the House that Sir John Wolfenden has agreed to take up that post.

Mrs. E. M. Braddock: Can the right hon. Gentleman say upon what date the necessary legislation will be introduced to establish the national councils, as recommended in the Younghusband Report?

Mr. Powell: These national councils and the lines on which they are set up will determine the future of these professions for years to come. It is overwhelmingly important that they should be established on the right lines.

Mrs. Braddock: When?

Mr. Powell: My right hon. Friend the Secretary of State for Scotland and I will wish forthwith to consult the prospective chairman and work out the details of the establishment of these councils.

Mrs. Braddock: When?

Mr. Powell: It would be quite incorrect to refer to the local authority health services as if they could be divorced from the general practitioner service, for it is a platitude, and perhaps too much of a platitude, to say that the general practitioner is the leader of a team most of whose members belong to the local health service. The general practitioner


service has been substantially strengthened in the last few years. In the last five years there has been an increase of 5 per cent. in the number of general practitioners, and the improved distribution of family doctors is reflected by the fact that since 1952 the population in areas which are under-doctored has fallen from 21 million to 9 million. My right hon. Friend the Secretary of State and I are having re-examined the data and calculations which underlie the estimate of the future of the size of the profession in the Willink Report.
Finally, I should like to refer to the general dental service. [HON. MEMBERS: "Oh."] It is of some importance and I should have thought it would have been a source of gratification to the whole House to know that in the last five years we have had a 10 per cent. increase in the number of dentists working in the general dental service, and the treatments given have increased more than in proportion, in fact by 25 per cent.

Mr. Thomas Steele: What about the schools?

Mr. Powell: And very germane to the immediate subject of charge is the fact that treatments not involving dentures but treatments involving preservation of the teeth have doubled since 1951 when the charges for appliances were introduced.

Mr. McMaster: Before my right hon. Friend leaves the general topic of personnel, may I ask whether he would like to refer to the long hours worked by and the low pay of dental nurses, district nurses and ordinary nurses in our hospitals and the need to increase that pay?

Mr. Powell: I quite agree with my hon. Friend that the hours which are worked by nurses and the pay are a material factor in the staffing of this aspect of the Service, and with him I would entirely dissociate myself from the point of view of the right hon. Member for Belper who seemed to think that an element of cost which arose out of the pay of those working in the Service was something which could be disregarded—something which is not integral. On the contrary, if there is expenditure that is more important than any other, it is expenditure upon the

human element of the National Health Service.

Mr. G. Brown: The Minister charged that my point of view was that this element of cost could be disregarded. I never said that or anything like it. I said that it should not be put on the patients by way of a direct charge, and so far the right hon. Gentleman has spoken for half an hour and has not mentioned either of the things that are involved in the Bill.

Mr. Powell: But what I have been talking about is that National Health Service which the Opposition charges the Government with the determination to undermine, and I am content to leave it to the House and to the country to decide whether a Service which has that record behind it and which has those prospects and plans for future development is one which the Government are determined to undermine.
But these developments which I have been describing are inevitably and necessarily reflected in the cost of the Service, in its gross cost, in its cost as a proportion of the national income and in its cost to the Exchequer. The gross cost of this Service last year rose by 6 per cent. It rose this year by 7 per cent. and next year it will rise by nearly 10 per cent. My figures, I think, are on a slightly different basis from those of the right hon. Member for Belper, but the general effect of the curve is not substantially different. The proportion of the gross national income which the Service absorbs has increased over the last five years from 3· 2 per cent. to 3· 8 per cent., which is equal to the highest point at which it has ever stood, and it seems clear that the proportion which will be taken next year must be higher still.
These increases which reflect the development of the Service are in turn reflected in the net cost of the Service to the Exchequer which, as I told the House last week, had increased by 6+ per cent. last year and by 8½ per cent. this year and, but for the Government's proposals, would increase next year by 11 per cent. Even after the proposed changes are made, the net cost of the Service to the Exchequer will have increased over three years by about 20 per cent.
All hon. Members, in whatever part of the House they sit, are perfectly well aware that a rate of increase in the cost


to the Exchequer of that order cannot continue without one of two things happening—either the development of the Service being limited, or an adjustment being made in the financing of the Service. [HON. MEMBERS: "NO."] This was what hon. Members opposite themselves discovered. The right hon. Member for Belper referred to the Korean War, but the point is that the party opposite also came to the conclusion that there was a point beyond which the increasing cost of the Service could not be put upon general taxation.
Hon. and right hon. Members opposite are not a party which has any aversion to high rates of taxation, but they came to the conclusion that there was a point beyond which the increased net cost could not be borne upon general taxation. [An HON. MEMBER: "Party politics."] This is not a party point. It goes much deeper. That is the lesson of the experience of the party opposite in the year in which the proportion of the national income which the Service was taking was the same as that which has again been reached. What is done when in this situation the decision is taken not to curtail the development of the Service but to adjust the financing 1s not that the service is undermined; it is that the Service is under-pinned.

Mr. K. Robinson: It is quite untrue to say that the percentage borne by the Exchequer now is no lower than it was when the Labour Government were in power, but we will deal with that later. I want to ask the right hon. Gentleman a question. He said that, after the changes that he has announced, the increase in the net cost to the Exchequer over three years will be 20 per cent. He gave us the previous increases annually. Will he tell us what next year's increase will be after the changes?

Mr. Powell: I apologise to the hon. Gentleman. He is quite correct. The increase over the three years is 6½ per cent. plus 8½ per cent. plus 3 per cent. cumulative.
The second point to which the Motion asks us to direct attention is whether this adjustment of the finances of the Service places heavy burdens on those least able to bear them. There are three

classes of measure which the Government propose, and I want to consider them separately.
The first is the increase in the National Health Service contribution. It is said—and, broadly, it is rightly said—that this contribution, like the flat-rate National Insurance contribution, is of the nature of a poll tax. It falls irrespective of the earnings of the person by whom it is paid. But in deciding whether such a tax is fair or not we have to consider whether it is in the right relationship to the earnings of those who will pay it and in the right relationship to other sources of finance.
There can be no absolute, no mathematical, standard of what is right and fair in such relationships, but I appeal to the decisions and the views in this matter which this House has taken over the last fifteen years. In 1946 this House, with a slightly different composition, set up the National Insurance Scheme and the National Health Service, and, in doing so, established the flat rate or poll tax from which there was to be an element specifically allocated which would be carried to the credit of the National Health Service.
I think it is a fair test to see how the flat-rate contribution today, after these changes, will compare with the flat-rate contribution which was thought right by Parliament when it was setting up the National Insurance Scheme and the National Health Service. If we look at the situation in 1946 when the total stamp, including the National Health Service element, was fixed at 4s. 11d., we find that the average male earnings at the time were 114s. 1d. per week, or a ratio of 4· 3 per cent. If we take as the fairest comparison the stamp which will be paid by a flat-rate contributor—that is, a contracted-out contributor—in future and compare that amount with current earnings, we find that the ratio is just over 4 per cent. So, in fact, the ratio which the flat-rate contribution for all purposes bears to average earnings today is less than that which was thought right by Parliament when the National Health Service and the National Insurance Scheme were established.
Those who say that this bears unfairly and unevenly—I am appealing to the verdict of this House when it established these Services—on the lower-paid workers must address themselves to the task of proving that the relationship between the


lowest earnings and the average earnings is more unfavourable today than it was in 1946; and I should like to see them make a start on that.

Mr. Harold Wilson: Is the right hon. Gentleman really trying to suggest that we cannot afford a better situation now, fifteen years after the war, than we were able to one year after the war in this respect? Also, since he is arguing that this is the right relationship between the contribution on the one hand and taxation on the other, will he now give a pledge on behalf of the Government that the next time the Chancellor has any hand-outs to give he will remit these changes before he remits the taxation of well-to-do taxpayers?

Mr. Powell: I am arguing that this is a relationship which this House itself has thought quite right, and that if it was fair in the circumstances of a wage of 114s. a week, it is fair on a wage of 300s. a week, which is the average today.
The other test which falls to be applied to a flat-rate tax is whether the right proportion is being maintained between the financing of the Service from the flat-rate element and from the other sources. The right hon. Gentleman mistakes the nature of this argument. Here, again, one as looking at what this House, when it established the National Health Service, believed in the light of the facts of those times was the right proportion to be borne by the contributory element—the credit from the National Insurance stamp—towards the whole cost of the Service. What we are looking for is the standard which was then considered—indeed, by all parties—to be fair.
If we make that comparison we find that the decision in 1946 was that it would be fair for 21 or 22 per cent. of the cost of the Service to be borne by the contribution. Today, after the contribution is increased, only 16· 7 per cent. of the cost of the Service will be borne by the contribution, and even if one throws in all the charges for good measure, the figure is still approximately the same as was considered to be right in 1946—when the national income, the earning capacity, and the level of earnings were substantially lower than they are today

Now I come to the second element in these proposals—the proposal to charge cost price for the vitamin supplements. I would remind the House, as the right hon. Gentleman did in part, of the history of these vitamin supplements. They were a siege measure which was introduced when this country was in a state of siege during the war, when it was difficult to obtain sufficient normal food for the population. Therefore, the decision was rightly and wisely taken to safeguard the vitamin requirements of the children and the mothers.
But it is also pertinent to remind the House that it was thought quite right in those dark days when we were under siege to charge for these vitamin supplements—5d. for the orange juice, 10d. for the cod liver oil and 10d. for the vitamin tablets. It was only in 1946 that the indiscriminate subsidy was introduced by the party opposite. Hon. Member's opposite really are living in an unreal world if they imagine that in the 1960's the vast majority of the mothers who take their children to the local authority clinics are not both able and willing to purchase the vitamin supplements which their children require, just like every other element of family requirements in the condition of the high standard of living of the 1960's.
An indiscriminate subsidy for this purpose is no longer necessary. What we need, of course, is something which will get at the families which are in real need and in real risk of being neglected. [Interruption.] I understand, of course, that hon. Members opposite would like to subsidise everything; but that is not the keynote of the society of the 1960's.
The way in which we can get at the families who are in real need of these vitamin supplements, the families who do not come to the local authority clinics, is through the local authority health visitor. It is through the local authority health service that we can get at the families who need this supplementation and who need advice and help in getting it.
So far as there is any barrier by way of means, that is then completely dealt with, because not only do all recipients in families where there is a regular National Assistance grant receive the welfare goods free—and that scheme will be extended to cover all the vitamin supplements in future—but the National


Assistance Board will make these available free of charge to families which are above the National Assistance Board standard on the same basis as I shall explain presently, when dealing with charges. To the charges I accordingly now come.

Mr. Ross: Will the Minister tell us what he said in April, 1951, would happen to those in need?

Mr. Powell: We are bringing assistance to those who need it.

Mr. Ross: Mr. Rossrose —

Hon. Members: Give way.

Mr. Deputy-Speaker (Sir Gordon Touche): Order. If the Minister does not give way, the hon. Member must resume his seat.

Mr. Powell: We are told that the charges which are being increased for dentures and spectacles, and the prescription charge, represent a charging of the sick. This can hardly be said to apply to the increased charges for dentures and spectacles, which increases in any case are not only exactly in proportion to the increased cost of supplying the articles but are tiny and negligible in comparison with the increase in all kinds of benefits and earnings since those charges were fixed.
I come now to the prescription charge. I emphasise that this is not an alternative to other measures directed to limiting the cost of the pharmaceutical services. The new voluntary price regulation scheme has opened the means of very effective negotiation with the pharmaceutical industry, which is being vigorously pursued, and a number of other measures will be taken in coming months which will assist in economical prescribing in the general medical service within the full professional discretion of the medical profession.

Mr. H. Wilson: On this pharmaceutical point, the right hon. Gentleman will remember that when, for example, in the 'forties we had price control of consumer goods with no Government money involved, the Board of Trade and other Departments had full access to the costs of the manufacturers concerned before deciding what a fair price should be.

The right hon. Gentleman's Department has so far not obtained any cost figures from any of the pharmaceutical manufacturers either for production or for advertising expenditure, which we know is very costly. Therefore, as the right hon. Gentleman says that it is going to be vigorously pursued, will he tell us whether the Ministry of Health will insist on getting full costing from firms which are taking so much of the taxpayers' money? Will he also insist that they limit their advertising expenditure and open up their patents to the Crown?

Mr. Powell: The negotiations to which I referred will involve discussions on, and disclosure of, costs. I assure the right hon. Gentleman that the Government will not overlook any genuine possibility of securing a true economic price for the drugs supplied through the pharmaceutical services.

Mr. Dan Jones: Including excess profits?

Mr. Powell: Coming to the prescription charge, even of this charge it is not true to say, as a whole, that it is a charged placed on the sick, because, of course, this charge in many cases will be paid by those who are earning where the prescriptions are made out to dependants. It is not true to say that over a great part of the field the cost of this charge will be borne by those who are sick.
I ask the House to consider the movement of benefits of all kinds, earnings, and of capacity to pay since this House thought that it was right to legislate to impose the 1s. prescription charge. As the right hon. Gentleman quite candidly said, that was in 1949. It was in 1949 that it was thought that to supplement other forms of taxable capacity it was right to make this charge. It was not thought that other forms of taxation should be used instead. That is the point.
Since then benefits have more than doubled. Wages have far more than doubled. Even if one takes 1952, the point of time at which the 1s. charge was imposed, both benefits and wages have practically doubled. It is the most ludicrous exaggeration to say that, by and large, the 2s. prescription charge is any more unfair and any more a burden than the 1s. charge in 1949.
I come now to the qualifications to that. I recognise that there are a number of special cases where provision needs to be made. For example, where prescriptions are regularly required by those who are chronically sick, doctors are not only able but are advised to prescribe for two or three months' requirements so that the increase in cost in those cases is negligible. I know that in many cases of chronic sickness it is not practicable to make a prescription for as long a period as that, and I had worked out, as an example, a diabetic patient's prescription which had to be renewed every four to six weeks. That worked out as a net increase on the average over the year at 8d. a week.
What I want to place on record here are the arrangements which exist, where there is the possibility of these charges causing genuine hardship, for their being refunded or for the money to pay for them being obtainable. First, all charges are recoverable in respect of recognised war disabilities. There is no question, as there never has been in the past, of any of these charges falling on the war disabled in respect of their war disabilities.
Secondly, all those who are in regular receipt of payments from the National Assistance Board can obtain across the counter at any post office a refund of any of the charges, and where those people are unable to go to a post office by reason of sickness or infirmity, arrangements exist for them to be collected by a third party.
But it is not only those who are in regular receipt of National Assistance who are entitled to refunds. The National Assistance Board will refund also to people who are above its normal standards of need, including people who are in employment. I think that the House will be interested in the higher allowances, disregards and standards which the National Assistance Board applies for the purpose of refund of charges.
For this purpose the Board allows expenses in connection with employment, such as fares to and from work, superannuation contributions, and trade union subscriptions. In addition, items such as mortgage repayments, hire-purchase and insurance premiums are taken into account and up to 40s. of net

earnings are disregarded. In the case of the prescription charge a higher basic standard, by 2s. or 3s., is applied after all these additional allowances and disregards have been made. It is in the public interest that those arrangements should be as widely known as possible. They make it clear that for a great many people who may be involved, by these charges, in some degree of hardship, but who are not within the normal limits of the National Assistance Board standards, repayment of the charge can be obtained. The more widely that is known the better.
I should also add that in cases where there is a cash difficulty the Board will make arrangements for the refund, so to speak, to be made in advance and the payment to be made before the chemist has to be paid.

Mr. George Lawson: Will the Minister tell us how many people above the National Assistance scale have been unable to have those refunds made?

Mr. Powell: I am sorry; I have not the figure. I hope that what I have said will result in any person who thinks he may be within the limits of those arrangements obtaining a refund under them.
This afternoon I renew the pledge made by my predecessor that he would examine any case of potential hardship under these arrangements which was brought to his attention.

Mr. K. Robinson: I happen to have the figures from the Ministry of Pensions about refunds to claimants who are not receiving National Assistance. The total cost to the National Assistance Board over the last three years has been £33,000, £35,000 and, in 1960, £32,000.

Mr. Powell: I am not sure what that proves. It rather suggests that there cannot be very many persons within this band of need.

Miss Margaret Herbison: On a point of order. The Minister is dealing with a most important matter, which affects many people. [HON. MEMBERS: "Point of order!"] This is a matter of the greatest importance to many people, and it seems to me that on the occasions when I have tried to


intervene the Minister has not given way because he knows quite well that I have his own statement of 1951 in my own hand.

Mr. Deputy-Speaker: That is not a point of order.

Mr. Powell: I will not close—

Dame Irene Ward: Does not my right hon. Friend think that these low figures may be due to the fact that even the present arrangements have not been given sufficient publicity? Will he ensure that the statement that he has made today is circulated to citizens' advice bureaux, to doctors, to chemists, to local authorities and to all those voluntary organisations who come into contact with the people in whom he is interested?

Mr. Powell: I will do all that I can—

Miss Herbison: Miss Herbisonrose —

Mr. Deputy-Speaker: I hope that the hon. Lady will resume her seat.

Mr. Powell: I will do—

Mr. William Baxter (West Stirlingshire): Why is it that the Minister will not give way to an hon. Member representing a Scottish constituency?

Mr. Deputy-Speaker: That is not a point of order.

Mr. Powell: Although it is not a point of order, I will answer it. I gave way to my hon. Friend the Member for Tynemouth (Dame Irene Ward) because she had a good point. I will do the best I can to give the widest publicity to the arrangements that I have announced.

Mr. H. Wilson: On a point of order. Why does the right hon. Gentleman give way to someone from his own side but not to my hon. Friend the Member for Lanarkshire, North (Miss Herbison)? If it is because he knows that my hon. Friend has in her hands the quotation from—

Mr. Deputy-Speaker: Order. The right hon. Gentleman is obviously not proceeding on a point of order.

Mr. Powell: In replying to the Motion, which refers to the undermining of the

National Health Service, I will not close—

Several Hon. Members: Several Hon. Membersrose —

Mr. Deputy-Speaker: I must ask hon. Members to resume their seats.

Mr. Powell: In replying to the Motion, which refers to the undermining of the National Health Service, I will not close with these matters which, important though they are, are of comparatively minor dimensions in relation to the Service as a whole. I would refer the House again to the background against which the debate is taking place. It is a background of the steady development, year by year, of this Service, which both sides of the House have created—[HON. MEMBERS: "Oh"]—and whose future hon. Members on both sides wish to be safeguarded. All, if they are honest with themselves, must recognise that that future would be jeopardised if measures such as the Government are proposing were not taken at this stage.
What I have shown is that this can be done without departing from lines which have been laid down in the past and thought to be fair and reasonable by Parliament, and without imposing hardship or an unreasonable burden upon anybody. I ask the House to reject the Motion.

5.50 p.m.

Mr. G. A. Pargiter: Seldom have we heard a worse defence of a bad case—I think that in those words one might sum up all that one could say. First, we were treated to a policy of planning for the future with regard to hospitals, plans which we know from past experience will "go west" at the first financial crisis, because if there is a financial crisis the first thing to go will be the money for hospitals. That will happen in the same way as it has happened on other occasions in respect of money designed for schools. We are under no illusions about what the Tories mean by these things.
The fact that these charges items are being dealt with at this stage would seem to make this the first instalment of what we may expect for the future. The Minister talked about the expansion of the Health Service. This is a rather late conversion but it is a conversion which has come since the introduction of the


block grant. If the Service had been expanded under the old system the Exchequer would have been responsible for 50 per cent. of the cost. While for a short period the Exchequer contribution must be maintained at a certain percentage, there is no guarantee under the block grant system that the percentage will be maintained, and so the usual thing will happen that we are accustomed to get from Tory Ministers. There will be pressure to extend services the cost of which falls more heavily on the ratepayer and less heavily on the Exchequer.
I am interested to learn that authorities are being requested to speed up their requests for capital expenditure. My experience has been the opposite, and that we have had to beg in the past for something to be done. On occasions we have been successful, but that does not alter the fact that had there not been pressure upon the Minister nothing would have been done. There has been no pressure from the Minister; the pressure has been the other way. We have bad to plead to be allowed to get on with many of the schemes to which the Minister is now giving lip-service. That is the background.
We accept the need for the modernisation of hospitals. That has been accepted for many years and the programme has been long delayed. I can only hope that it will proceed as well as the Minister anticipates and will not be interrupted. We have this much to think about. It was not for nothing that a kite was flown regarding the imposition of a charge for the food supplied in hospitals. It is the usual practice to fly a kite about a proposal and play it down, and then later it is introduced. I have an idea that before very long some Minister—not perhaps the present Minister, because I do not think his showing today has enhanced his status—will say, "We have all these fine plans for the hospitals and we are going to improve them, and all the things will be done that will humanise the Service. But the cost is going up, and in order to keep it properly in balance between the various sections, we shall have to make a charge." It is obvious that the charge will be in respect of the provision of meals in hospitals. At any rate, even if it be denied now it will be interesting to see whether that will happen in the near future.
I am wondering why, when he was dealing with the question of orange juice, vitamins and such things, the Minister did not say anything about welfare milk. This is another thing about which a kite is being flown in some quarters. The Minister would be under considerable pressure from the Milk Marketing Board if he did anything to stop the consumption of milk. The problem today is to maintain the consumption of milk and any Government action to reduce it would create difficulties in other directions. So perhaps we can understand why these proposals are limited to orange juice, to ood liver oil, vitamins and things of that kind. But we are still suspicious and we anticipate that this is only the first instalment of what the Minister and the Cabinet intend to do.
The right hon. Gentleman made no answer to the case put by my right hon. Friend the Member for Belper (Mr. G. Brown). He brushed aside the specific questions which were put to him, but they still remain pertinent questions which will have to be answered. There is a fundamental difference between the approach to this matter by hon. Members on this side of the House and by hon. Members opposite. In 1945 our intention was to have a free Health Service. It is true that a modification was made at the beginning of the Korean War to meet the situation existing at that time. But a promise was made that this was intended to be a temporary modification. Hon. Members opposite have carefully ignored the fact that it was the intention of the Labour Government to make the modifications temporary because we were committed to a free Health Service which would be available to rich and poor alike. There was to be no question of any difference between one person and another.
We recognise, of course, that from a snob point of view some people choose not to use the Service or to use only a part of it which is expensive, they want free drugs or drugs which will cost them only a few shillings. It will probably be a useful argument for the Minister, who will be able to say to his back bench colleagues, "Now I am putting up the charges it is no use asking that private patients should be treated in the


same way as Health Service patients regarding drugs. It would not do at the present time, so please pipe down."
What is meant by this question of a 2s. charge? There are many items which will appear on prescriptions which will not cost 2s. and many will cost only just about 2s. What is a doctor to do about such items? Will he put them on the prescription if they cost less than 2s. and say nothing to the patient, who will thus be getting something of a lesser value than he has paid for? Or will the doctor say, "All right, I only wanted to prescribe a certain amount, but if I prescribe double the amount that will justify the payment"? Alternatively, will the chemist have to administer this? Will the chemist have to say, "I am sorry about this, you had better buy this item over the counter and it will cost you less"? I do not know whether a chemist is entitled to cross an item off the prescription—[HON. MEMBERS: "He is not."]—or what is he to do?

Dr. J. Dickson Mabon: My hon. Friend asks whether a chemist can strike an item off a prescription. I think that the Minister is saying, "Yes". I am surprised and I am sure that my hon. Friend will appreciate the information which I can give him. The Scottish Executive Council called attention to this when I raised the matter and insisted that not only was this a bad practice by the chemist but something to which doctors objected. I am sure that my hon. Friend will agree that it is wrong that a chemist should have to answer questions which the patient may ask, such as, "Which medicine shall I take, this one or that one?"

Mr. Pargiter: I am grateful to my hon. Friend for the information he has given which pinpoints an important part of the case I am endeavouring to make.
What is the chemist to do? If he cannot take the item off the prescription, is he to say to the patient, "If you buy this over the counter it will cost you 1s. If I prescribe it, it will cost you 2s."? Is he to leave the item on the prescription and make a note that this item has not been prescribed? One can imagine the amount of administrative work involved in matters of this kind. It could be quite fantastic. I

hope that the Minister will not think that these are small issues. They are very important administrative issues, quite apart from the health point of view, and I consider them matters to which attention should be given.
I could understand if the Minister said that they were in difficulties about the question of making a charge for each item on a prescription and, therefore, they would impose an overall prescription charge, or something of that kind. That was the intention of the Labour Government, to have a prescription charge and not to itemise the charge. But the Tory Government made it an itemised charge. Why not examine the problem which is thus created to see whether some other solution may be found? But I may as well make it clear that no solution will be satisfactory to hon. Members on this side of the House except the complete abolition of these charges.
I wish now to deal with another matter, the provision of bifocal lenses. If a doctor prescribes certain drugs which are more expensive than others, it is not a question of making an additional charge, the charge is the same. But if an ophthalmic surgeon or an optician prescribes bifocal lenses because they are necessary, the argument is that they are more expensive and therefore the patient must pay more for them. That does not seem to me a good argument.
The argument may hold good that a person requires something and, therefore, there has to be a prescription charge, whatever it may be, but the person who requires bifocal lenses should not be at a disadvantage compared with one who does not. As I am getting older, I happen to know that bifocal lenses are a great advantage as one gets older. It is people who are getting older who, therefore, have a greater need and they will have to pay the most. I think it has been established and that it is accepted by some opticians that some people have bifocal lenses instead of single lenses prescribed because that may off-set the oncoming of certain types of eye diseases. That is a secondary point. The main point is that, if the need is there and a charge has to be made, it ought not to be a discriminatory charge.
I should like to hear the answer of the Minister to that, but I think that the answer is that the Government find it necessary to scrape the barrel in order to get all they can to provide for tax reductions which the Chancellor of the Exchequer will hand out in other directions. Our main charge is that this is another deliberate attempt to depart from the principles of a free Health Service.
I was in the House at the time and I recollect that the Tory Party voted against the Third Reading of the National Health Service Bill. There is no question about that. It is no use hon. Members opposite saying that they were in favour of it. They may say, "We did not like this part or that part", but the fact remains that they voted against the Bill and it is on record that they voted against it. Despite that, the public has come to accept the Welfare State as a fact and as something desirable, so hon. Members opposite have changed their tune. In due course they will change it again if they find that they are becoming too unpopular.
Much has been made of the cost of drugs. We have had very little evidence about what the Government have done on this question. We have heard about the importation of continental drugs, which may or may not be of the same standard as those produced here. I do not know, but one thing which may be said for English drugs is that the standard is generally high. That would be admitted on all sides. It may be higher than that of some of the continental drugs which are brought in as alternatives. That is not the answer. Our charge is that, because the cost of drugs is too high, the Minister, rather than dealing with that aspect of the problem because it would hit his friends, says. "The cost of drugs is high, so the charge has to be higher to the sick and needy"
The right hon. Gentleman made a wonderfully impressive statement about allowances for mortgage repayments and hire purchase and so on, that was all in order to justify a prescription charge and, above all, in the hope that the procedure will be so complicated and will so stink of the means test that people will not use it. The more publicity he gives to that scheme and the more restrictions which surround it. the fewer people will

use it. This was one of the worst aspects of the pre-war means test to which we became accustomed in the thirties. It might be argued that, because the economy is in a bad way, these things are necessary, but the two propositions do not tie up. Hon. Members opposite cannot have their cake and eat it. They cannot go about preaching, "You have never had it so good", and then saying that the cost of a few millions for the National Health Service is something which the Exchequer cannot bear.
Obviously hon. Members opposite will troop sheepishly into the Lobbies against this Motion, as they always do when these things are discussed, no matter what their real feelings may be. They will say to their somewhat irate supporters, whom they hope will vote for them again, "I did not like this, but it was a Government decision and I had to support it." Let us hope that some of them will have the courage of their convictions and will go back to the principles to which they give lip-service, so that we may have a proper Health Service on the basis of the cost being borne by those who can afford to pay. That is precisely our case, which is also that those who cannot afford to pay shall receive the health services that they need.
Frequently we are told how important health is and what a great advantage to the economy it is to have a healthy nation. Yet all the time we get this chiselling—not underpinning, but chiselling—at such a service because that fits with the Tory ideas of the economy. I should like to see this Motion carried. Although it will not be carried in this House, I am confident that it will be carried in the country.

6.6 p.m.

Mr. Jasper More: I ask the indulgence of the House for this my first contribution to a debate. Having listened with respect to the speech of the hon. Member for Southall (Mr. Pargiter), I express my regret that it did not contain more reference to what I think many hon. Members will regard as by far the most important sentence in the statement of my right hon. Friend the Minister which gave rise to the Motion before the House. That sentence was:
The Government are determined … to carry through a long-term programme of modernising our hospitals."—[OFFICIAL REPORT. 1st February. 1961: Vol. 633, c. 988.]


My right hon. Friend has claimed that that message has given renewed hope to those responsible for hospital administration through our hospital boards. It was my fate for a number of years to be a member of a hospital group management committee, the Shrewsbury Group. I can truly say that for many years it was a frustrating experience, and I can entirely endorse what my right hon. Friend has claimed, that he has now given us a new message of hope. The right hon. Member for Belper (Mr. G. Brown) listed in his speech a number of cases of waste in the National Health Service. So far as I was able to follow him, he did not list the item which to anybody who has served on a management committee is the outstanding example of waste in this Service, the need to spend money to keep going out-dated hospitals.
In my hospital district, we have had cases in which we have had to spend tens of thousands of pounds to preserve buildings which we knew were not worth preserving. In my constituency of Ludlow, there is a hospital which we call a hospital only by courtesy. It is thought better that in the Welfare State it should be so called, although we all know that in fact it is a workhouse. which was built in 1838. It was built of stone which is now crumbling inside and outside. It was built in the form we so well know, the form of a cross with a central structure and four courtyards. In the basement and the ground floor we have modernised the kitchen. Meals have to be carried up a narrow, winding stone stairway to patients on the first floor. Fortunately, they do not have to be carried to the second floor because that has been condemned as unfit for any use whatever.
In the central structure on the first floor, one goes straight into the world of Dickens, by entering that curious octagonal chamber which some hon. Members may have experienced, where four doors lead into the four arms of the building and four windows overlook the four courtyards. From one of the windows one has a view of the stone-breaking cells where casual visitors were put in former days, and one can see the metal grille through which at the end of the day they had to throw the broken stones.
I visited this hospital a few days ago. The feature of this hospital, which I am afraid is typical of many of our old hospitals, is that in essentials it does not change but in inessentials it changes all the time. Such essentials as lifts, X-ray departments and an operating theatre, of course we do not have. But on nonessentials there is poured forth a never-ending stream of public money. We paint the walls. If the stone will take the plaster, we plaster the walls. We re-arrange the rooms and put up partitions. We pull up the stone flags and put down new floors. We try to improve the lighting. We have even converted the stone-breaking cells into stores.
We do all these things in the sure and certain knowledge that we are wasting and throwing away public money on a building which ought not to exist. We do so because we know that unless we do this, it will not be possible to keep that hospital in operation at all. Hon. Members will understand when I say that it has been a frustrating experience to be a member of a group hospital management committee.
Hon. Members are no doubt aware, but is the country aware, of the state of the capital investment in our hospitals? An investigation was carried out some six years ago by the Institute of Economic and Social Research. The Institute estimated that in the 1930's, before the hospitals were nationalised—and taking account of differences in wages and prices—about £30 million a year was being spent on the capital reconstruction or building of hospitals. In the years which followed the institution of our National Health Service, the comparable figure, as the Minister has told us, was £9 million—£10 million—£11 million. It has risen, if I am right, to £25 million in the present year and will rise next year to £31 million. Under the programme which the Minister has announced it will rise to £50 million. The figures which I have given are an indication of the degree to which we have fallen behind even in the bare business of maintaining our standards. It was estimated by the secretary of the regional board under which I served that at the rate of progress achieved in the first seven years of our National Health Service, it would take 250 years to rebuild all the hospitals in that region.
It is one of the great tragedies that when this scheme was launched in 1948 the public was left with the impression that we were unlocking a Garden of Eden into which they had only to enter to find everything perfect. As we know from these figures—and surely in cold print these figures are no less incredible than the Ludlow Hospital in cold fact—the National Health Service, financially speaking, has been living on the past. We have not even been paying for the present. Under the proposals which the Minister has put before us we shall not only be paying for the present but we shall begin to pay for the future.
I suggest that the time is long overdue for the public to be shocked into an awareness of the situation. We are now being asked to pay for our present hospital service and to pay for the future. As one who has served in the service, I am glad that we are being asked to pay for it within the ambit of the service itself. I admire the Minister's courage, and I am sure that the vast majority of those who are engaged in the service will give him their fullest support.
No one doubts or denies that this expenditure must involve a new and heavy liability on our community, but I believe that if the present proposals are courageously carried through, at whatever the cost to our own generation, we shall be doing something which will ensure that future generations will look back upon this as the starting point of a new and happier era of our National Health Service.

6.17 p.m.

Miss Margaret Herbison: I have great pleasure in complimenting and congratulating the hon. Member for Ludlow (Mr. More) on his maiden speech. When one listens to a maiden speech, it is pleasant to know that the hon. Member is speaking from experience and from deep conviction. Running through the whole of the hon. Member's speech were both knowledge and conviction. I am sure that we all hope to have the benefit of his experience in future health debates and other debates, particularly when we consider the problem of giving the country the hospitals which he realises it so desperately needs.
I turn to the subject of the debate. I consider that we had a most brilliant

speech from my right hon. Friend the Member for Belper (Mr. G. Brown), who put these charges in the proper perspective. He made it clear, not only to the House but to the country, why these charges were being imposed at present and on whom they would fall most heavily.
We then listened to the Minister of Health. The more I listen to him the more I believe that he is not a Minister of Health at all; he is a Minister of the Treasury with the name of Minister of Health attached. It is not very long ago that he resigned as a junior Treasury Minister. Why? Because his Government at that time were not willing to make a cut of £50 million in the social services. It is not that his Government did not want to do these things. His Government decided that it was most inopportune at the time to effect these cuts; it was too near an election. Because it was too near an election, the hon. Member and his right hon. Friend the Member for Monmouth (Mr. Thorneycroft) were sacrificed by the Government.
The Government won that election, but not only on matters of health but on many other matters, they won it on a false prospectus. Every month that the Government remain in office proves more and more how false that prospectus was. The present Minister of Health was appointed not to ensure that we had a better health service but to ensure that there was a Minister in that position who would gladly—and I say "gladly" advisedly—operate the cuts. As far back as 1st May, 1952, the present Minister said this, as a back bencher:
I also believe it is generally recognised that, if we are to have expansion in those branches of the Service where it is most urgent … then that money has got to be found by other means within the Service."—[OFFICIAL REPORT, 1st May, 1952; Vol. 499, c. 1780.]
The Minister used almost exactly the same words when he announced the cuts last week. He need not smile, because my case is that he was appointed specifically to administer the cuts, because it was well known that he would administer them.
As I come to the House every day, I see huge posters on almost every hoarding. They concern the council elections. On the posters in large lettering are the words, "Conservatives Care". The


Conservatives do not care for the old people. The Conservatives do not care for the chronic sick. The Conservatives do not care for those living on small fixed incomes. The Conservatives do not care for the lowest paid wage earners and their families. The Government have proved themselves to be a totally class Government. We have often been accused of fighting the class war.

Mr. Charles Loughlin: They practise it.

Miss Herbison: The Government fight it in a debate like this debate today and, as my hon. Friend says, practise it continually. Of course the Conservatives care for some people. They care for the Surtax payers particularly. They have great tenderness for those people. They have great tenderness for many people who could carry quite easily, without any hardship, a greater burden than the Government are willing to put on their shoulders.
The Minister of Health has a rigid one-track mind. He proved it as a back bencher. He has undoubtedly proved it as a front bencher. Today he posed again, just as he posed them in 1952, what he considers to be the only two alternatives in the Health Service. According to him, with his one-track mind, the two alternatives are—impose these charges or limit the Service, that is, limit expansion.
I will not denigrate the undoubted intelligence of the Minister. He was so intelligent this afternoon that he would not give way when he knew that I could pin what he was saying today as something which he just did not believe. However, I shall not denigrate his intelligence by suggesting that in 1952 or last week he was unaware or is unaware today that there is at least a third alternative which would not bear heavily on the poorest section but which would give us the kind of Health Service and the hospital buildings which all of us want to see.
The Minister made a very great deal out of the proposed capital investment in hospitals. He almost based the whole of his case on that. Today he purposely devoted a great part of his speech, not to dealing with the indictment of our Motion of censure, but again to saying

what the Government would do in the future. I can remember the Guillebaud Report. [HON. MEMBERS: "Hear, hear."] I am glad that hon. Gentlemen opposite remember it. I can remember the words of a previous Tory Minister of Health when speaking in the debate on the Guillebaud Report. These are his words:
Those are the recommendations regarding £30 million a year being a desirable rate of capital expenditure for the hospital service for Great Britain at which to aim over the seven years succeeding 1957–58."—(OFFICIAL REPORT, 7th May, 1956; Vol. 552, c. 858.]
We are now in 1961 and the Minister tells us that five years ago—that was after almost five years of Tory Government—we were spending under £10 million on capital investment in hospitals. He said that this year we are spending £25 million. As with so many Tory promises, it is to go up in future. They have lagged far behind what the Guillebaud Committee asked them to do. Now when they realise how desperate the hospital service is they are to take credit for what they propose to do, and they will place the burden on the poorest.
I was interested to read the editorial in The Guardian the morning after the Minister made his announcement. It said this:
But this growth in the health bill needs to be seen in its proper perspective.
This is not a Socialist publication. It continues:
To begin with, as the Treasury admitted in a recent ' Bulletin for Industry', expenditure on the Health Service has lagged behind that on other social services in recent years. This has meant that some branches of the service have been starved of badly needed funds..
Starved by whom? They have been starved by a Tory Government that all those years were telling us that we never had it so good. According to the Treasury's own statement, we have been starved of funds for the hospital service.
The editorial continues:
as Mr. Powell himself recognised earlier this month when announcing long overdue plans for modernising the hospitals.
The Minister is quite wrong now. because of the misdeeds of the Tories in the last few years in regard to hospital building and starving it of funds, to say that the only way we can get better hospitals now is by taking in charges and insurance contributions £50 million


this year, much of it from the poorest, and £65 million in a full year, according to his own statement.
The right hon. Gentleman has managed to win his point. When he was at the Treasury he wanted a £50 million cut from all the social services. As Minister of Health he is getting £65 million in one year from the National Health Service alone. People all over the country—not only those who support my hon. Friends and me, but all decent-minded people—oppose very strongly the charges that the Minister intends to make.
Talking about the charges, the right hon. Gentleman today outlined the three different categories which could all obtain help from the National Assistance Board. In other words, if there was any real hardship it would be dissipated completely by the National Assistance Board. His 1952 statement, his statement last week and his statement today on limitation of charges were all of a piece, but his statement today on the National Assistance Board and his speech on 24th April, 1951, were very different. I intend to put his speech on that occasion on record. He said:
Now from the point of view of the potential recipient, the people who are not going to be helped, who are not going to pass this means test, are precisely, in many cases, the most deserving. They are the people, the old-age pensioners, people just on a living wage, who are going to say, ' This is a pretty stiff sum I have got to pay, but I will be dashed if I am going to the National Assistance Board to argue the case about it.'
He went on to say:
Those are the people who are going to suffer most from these charges, if we leave this method of assessment in the Bill … we should envisage a wholly new approach, separate from the National Assistance Board, in the determination and administration of the means test".—' [OFFICIAL REPORT, 24th April, 1951; Vol. 487, c. 314.]
How different that statement from the one he made today—and one, I felt, that he made with such pleasure today. When I compare the Minister's speech when he was a back bencher with his speech today, I can only say that that part of today's speech was just sheer humbug. I do not believe for one moment that he believes it, but he had to make some case to try to ensure that people will believe that there will be no real hardship whatever in these cases.
On the very day after the Minister's announcement, a woman called at my

home. She was in great distress about these charges. She was told that I would not be at home until the Friday of that week, and she came again on the Friday night. Again, I was out—I had another engagement. She came back on the Saturday. She came to my home three times because of her worry. She is a diabetic and has a heart condition.
With the present charge of 1s. per item on a prescription she pays 5s. a fortnight. That will go up to 10s. a fortnight—£1 a month. Once a month she has to go from our village to a clinic, and that costs her 2s. in bus fares. That brings it to £1 2s. a month. Her heart pills, which usually last a week, cost 2s., so the total is £1 4s. a month. Her husband is an oncost worker, and they have two children. That woman is worried almost to death about what is to happen to her, but I would wager that if she now went to the National Assistance Board she would be told that, even according to the scales described by the Minister, the household income is too high to allow her to be reimbursed. The extra money that she will be asked to pay because she is a sick woman will come very largely from money that her family really need.
The present Secretary of State for the Colonies realised this, although he himself had many things to say about the National Health Service. On 27th March, 1952, he said:
 The last conclusion I wish to leave in the mind of my right hon. Friend is that I think I am right in believing that, particularly with the poorer people, health expenditure is a marginal expenditure and one of the first things which goes by the board if anything has to be paid for.
I am quite certain that that is why, immediately after the Minister's announcement, the British Medical Association declared itself opposed to these increased charges.
The Colonial Secretary went on in the same speech to say:
Surely then it follows that, if there is a much greater deterrent charge—and I hope that the Ministers will look at this—it may be that they will be able to come to the House and, by Order in Council, achieve what we are trying to achieve in this Bill with a much smaller charge."—[OFFICIAL REPORT. 27th March, 1952; Vol. 498, c. 964.]
That was in 1952, and the right hon. Gentleman was afraid even then that the charge—then 1s. per prescription—would prove to be too high for the


poorest people, and would be detrimental. Since then, a Tory Government has made it 1s. per item on a prescription and under this "Minister of the Treasury of Health" it will be 2s. per item.
One of the reasons he gave was the increase in the drug bill—in the price of the prescription. He gave us the exact figure; it has risen from 5s. l½ d. to 7s. 4d. That represents an average increase on each item of 43 per cent. from 1956, when the last increases were made. It means that this wonderful Minister of Health says to himself, "I will make an increased charge, but I will not increase it by 43 per cent. or by 50 per cent. I will raise it by 100 per cent."
Even his own case, therefore, does not stand up. He not only wants to cover what he thinks is a loss but wants to make a profit for the Treasury. It is a most scandalous thing to do. He is not afraid to harm the poorest of our people, he is not afraid to harm the chronic sick, but he is dead scared of doing anything against those who are making huge profits out of the pharmaceutical industry.
All doctors will tell of the advertisements they get, of how beautifully those advertisements are got up and how expensive they must be. That expenditure goes into the cost of the item that has increased by 43 per cent. Every doctor will say that his place is littered with free samples of what might be used—but not a word comes from this Minister of Health about what he would do about that matter. That is too difficult, and it does not suit the philosophy of the Tory Party. But it suits the Tory Party's philosophy beautifully—and particularly the philosophy of the Minister of Health—to attack those who can least afford to be attacked.
Another woman called at my home with a letter. Strangely enough, she, too, was a diabetic with a heart condition. Her husband must be too poor to pay Income Tax, but the Tories told him at the General Election, as they told all those earning under £9 a week, that their contribution was to be reduced. They were all told that when the new scheme came in in April their weekly contribution would be less. They were told that it would come down from 9s. 9d. to 8s. 7d.
As I say, that was at the time of the General Election. It now transpires that men earning less than £9 a week will, as a result of an increased charge imposed by a previous Measure and the charge to be imposed by the Bill that we are to debate tomorrow, have to pay 10s. 7d. a week. I know, because I have worked it out, that there are many thousands of men earning only up to £9 a week. What they will pay from 1st April will represent almost 6 per cent. of their incomes. What a shockingly progressive poll tax on the poorest in the country. When these people are off ill they will be worried to death about how they will meet this 2s. per item on the prescriptions.
The Minister has spoken about the need for better hospitals. At present, over half the hospital beds in the country are for the mentally sick. From what I saw of that woman who came to my home worried to death, it seems to me that there will be far more mental illness caused by the Minister of Health and these shocking charges that he is putting on. [An HON. MEMBER: "And the Secretary of State for Scotland."] Of course, the Secretary of State is just a poor fish. He follows what the Minister of Health gets his Cabinet to do. My indictment is against the Minister of Health because his whole history in this House has been to aim at cuts in the National Health Service.
There are many more points I wanted to raise tonight, but I know that a great many of my hon. Friends wish to speak in this debate.
Finally, on this third alternative, my hon. Friends in the debate yesterday showed the Government where they could get the money—a Government which, by their own actions, bring about the crises we have from time to time, a Government who are at the bottom of the league among many countries in exports and increased industrial production. They take advantage of that situation—I say "advantage" advisedly—to do what the Minister of Health and many Tories have always wanted to do. This is a matter of principle with the Minister—a matter of his deep Tory philosophy—that there should be these charges. If this Government had only


had the increase in industrial production and had maintained the same place in exports as we had under the Labour Government, the money would have been there for our hospital expansion.

Mr. G. Elfed Davies: They would still have done it.

Miss Herbison: I have already said they are doing it because they want to do it, but I want to show where they can get the money to do what should be done. In the two-day debate which we had, the Government clearly showed that they did not have a clue how to solve the economic difficulties. However, we did make it clear how they could have done it.
There is no doubt in our minds that there will be tax concessions in the Budget for the very best off people in the country. I believe in helping those who desperately need help. I believe that the majority of people in this country accept that. I say to the Minister that he should consider many of the points that will undoubtedly be put forward in this debate and that he should try to get away from his hidebound ideas and really be a Minister of Health, a Minister who is out to prevent ill health and who is out to cure ill health as speedily as possible.

6.45 p.m.

Lord Balniel: This is a debate on controversial proposals and no doubt I shall become involved in the controversy. Before I do so, I should like to congratulate—and I feel sure this is entirely non-controversial—my hon. Friend the Member for Ludlow (Mr. More) on a truly admirable maiden speech. He spoke from a personal knowledge of the hospital service and I feel I can say on behalf of the whole House that his speech was of a kind that will be welcome and that we wish to hear on many occasions in future.
There are many hon. Members on this side of the House who are glad to see Her Majesty's Opposition united once again. [HON. MEMBERS: "Oh."] I say that even though they are united in what, I recognise, is a kind of ritual dance along well-worn tracks of party politics. I would have preferred to have started by congratulating the right hon. Member for Belper (Mr. G. Brown)

on his introduction and the way in which he has led this ritual dance. I am afraid I cannot do so. Instead, I feel that I should commiserate with him that, on this occasion, he is not being partnered by the Leader of the Opposition. We fully understand the historical reasons which make it difficult for the Leader of the Opposition to take part in a debate on health.

Mr. Laurence Pavitt: I had the privilege in a previous health debate of following the noble Lord when he made a most knowledgeable speech. Will he return to his previous form and get on with the subject?

Lord Balniel: We all fully understand the reasons the Leader of the Opposition is not taking part in this debate and why he has decided to sit this one out.
Hon. Members opposite accuse us in our Motion of undermining the Health Service. I feel that they will forgive us if, for a moment in face of this accusation, they allow us to look back to the condition in which the Health Service was when we took office. We took office in 1951 when the Leader of the Opposition introduced his one and only Budget. That was the year in which the National Health Service charges went up and the right hon. Member for Huyton (Mr. H. Wilson) went out.
Hon. Members opposite also accuse us in their Motion of placing a heavy burden on those who are least able to bear it. [HON. MEMBERS: "Hear, hear."] If they applaud that sentiment they will allow us to look back for a moment to their last year of office, because it was in that year that the Trades Union Congress bitterly complained that the rising cost of living was imposing an increasing burden on the lower-income groups. If hon. Gentlemen will not take my word for it, perhaps I should quote the words of the Trades Union Congress. They accused hon. Members opposite of reducing the standard of living for the lower-income groups "below tolerable limits".
In their last year of office hon. Members opposite, as a kind of final firework display before the funeral they were soon to undergo, clamped down a totally arbitrary ceiling of £400 million on the Health Service. In doing so, they struck a blow at the Health Service without equal since the war.

Dr. Barnett Stross: The hon. Gentleman cannot get away with that, because we heard his right hon. Friend say categorically this afternoon that in that particular year, as a percentage of the gross national income, that was the highest amount of money spent until this very year when, at last, we are reaching back to it.

Lord Balniel: There is a total difference between the proposals of my right hon. Friend and the action of the hon. Gentlemen opposite in which they imposed a limit on the expansion of the Health Service. The whole theme of my right hon. Friend's proposals is to emphasise the expansion of the Health Service. In their last year of office, right hon. and hon. Members opposite imposed a ceiling of £400 million on the Health Service. Today, expenditure on the Health Service is £867 million.
I used to live in a part of the country where the overwhelming majority of the population were coal miners. Very few coal miners would find any real meaning in the word "undermining" in the Motion which the Opposition have put down. Indeed, by every yardstick I can think of, the Health Service today is immeasurably better than it was when we took over responsibility for the health of the nation.
The hospital building programme of right hon. and hon. Members opposite began and continued at the exhilarating rate of £10 million a year. Now, the hospital building programme is running at £500 million over the next ten years. An annual rate of £50 million a year for the hospital building programme hardly indicates that we intend to prune that part of the Service out of existence.
If the undermining is not taking place in the hospital building programme, is it taking place on the human side? Perhaps we are undermining the recruitment of doctors, nurses and consultants to the Health Service. The number of full-time nurses has risen by 23 per cent. in the last ten years. The number of part-time nurses has risen by 79 per cent. As every hon. Member knows, there has been a steady increase in the numbers of doctors, consultants and other persons in the Health Service.

Mr. Richard Marsh: Will the noble Lord say how large a proportion of the total he has referred to was the result of introducing nursing auxiliaries, State-enrolled assistant nurses and other untrained or semi-trained nursing staff because the Government could not attract qualified nursing staff?

Lord Balniel: I regret that I cannot differentiate, because I have not the figures with me, but I can say that the increase of 23 per cent. in the number of full-time nurses and of 79 per cent. in the number of part-time nurses is nothing of which we on these benches need to be ashamed. It is a move in the right direction, surely, which hon. Members should not carp at.
If the undermining is not taking place in hospital building or in recruitment of staff to the Health Service, perhaps it is the patients who are, so hon. Members opposite feel, getting a rotten deal from my right hon. Friend. One can only say that the number of in-patients cared for by the hospital service has increased during only the last five years by 10 per cent. The number of out-patients cared for by the hospital service has increased in the last five years by five per cent. More important, perhaps, in the hospital service is the fact that the number of domiciliary consultations during the last five years has increased by 30 per cent. One can hardly say that there is an undermining of the service for the patients.

Mrs. Harriet Slater: Will the noble Lord agree that the fact that hospitals have to take in more patients indicates that there is probably not enough preventive work, and that the 2s. prescription charge will mean that more people will now want hospital treatment?

Lord Balniel: I should have thought that the statistics I gave, particularly the increase of 30 per cent. in domiciliary consultations, were a complete answer to the question the hon. Lady has asked.

Mr. George Lawson: On a point of order, Mr. Speaker. The son of the Premier Earl of Scotland is speaking about the Health Service, and there is not a Scottish Minister on the Government Front Bench.

Mr. Speaker: That is not a point of order for me.

Lord Balniel: Perhaps I can speak for Scotland, in that case.
Our determination to improve the National Health Service and our determination to fulfil our ambition to diminish ill-health in this country and to remove suffering as much as possible has cost the country an immense sum of money. In terms which take account of the change in the value of money, there has, during the past ten years, been an increase in expenditure on the Health Service of one-quarter.
We are absolutely determined on these benches that we shall continue a high rate of investment in the essentials of the Health Service. There is—it would be foolish to fail to recognise it—a real danger that the very foundations of the Health Service will be imperilled by the rising cost to the taxpayer. If we ignored this danger, if we allowed the cost to the Exchequer to continue to soar, the inevitable result would be a reaction and a retrenchment as damaging to the Health Service as that undertaken by the late Sir Stafford Cripps which, as I have said, was a retrenchment very gravely resented by those who had dedicated their lives to the Service and damaging in a way which cannot possibly be compared with anything suggested since.
Hon. Members opposite are, of course, perfectly entitled to say that the rising cost of the Health Service should be borne by the Exchequer. They are perfectly entitled to say that the rising cost of the Service should be met out of increased taxation. All I can say about that is that it was not so very long ago that hon. Members opposite were involved in a General Election campaign and they were prancing round the country hawking the promise that, instead of increasing taxation, they would reduce direct taxation. I find it impossible to square the attitude of mind which the Opposition are adopting now with the promises with which they tried to delude the electorate at the last General Election.

Mr. Arthur Holt: The noble Lord, apparently, disapproves of the idea of any increase in the cost of the Health Service being carried by the taxpayer. What are the Government

doing now when they put 1s. on the stamp? Is not that a tax?

Lord Balniel: I meant direct taxation. I will come now to the point which the hon. Gentleman makes.
Faced with the increasing cost of the Health Service, we have, in my judgment, three clear alternatives. First, we could hold back, as the Opposition did, the expansion of the Health Service. We could put a ceiling on its costs. We could say, "Thus far and no farther". That was the course of action which right hon. and hon. Members opposite took in 1951. Were we to emulate them, were my right hon. Friend to take that course now, I should regard it as a gross betrayal of the real interests of the Heath Service. I should regard it as a betrayal of the interests of those who have dedicated their lives to the Service and a betrayal of the interests of the patients and the beneficiaries.
The need today in the Health Service is not to halt its expansion. The need is that it should continue its expansion unchecked, and nothing is more damaging to it than to place an arbitrary limit on it postponing planned progress and upsetting planned expansion.

Mr. Marsh: I agree entirely with the hon. Gentleman that we need to expand the Health Service, but will he tell us how many new hospitals his Government have built in the last nine years?

Lord Balniel: I have mentioned that. I said that when we came to office the annual expenditure on hospital building was £10 million. The annual expenditure on hospital building under my right hon. Friend's proposals is £50 million. It seems to me that an increase of that nature is something for which we can take credit.

Mr. Marsh: How many new hospitals have we had?

Lord Balniel: I am glad that in his proposals my right hon. Friend, faced with a difficult problem, has emphasised the need for the expansion and not the restriction of the Health Service.
The second course which faced us was that the whole of the increased cost of the Health Service could be borne by the taxpayer. It is claimed by hon. Members opposite that we are undermining the Health Service. But, surely,


if anything would undermine the Health Service it is higher taxation, because that would strike at the very roots on which the Heath Service depends. A demand for higher taxation would strike at the economic prosperity of the nation. The Health Service is built on the energy, earnings and productivity of the nation and, even at this moment, with the present level of taxation, those earnings, energy and productivity are being sapped. The Health Service is carried by the nation's earnings, and, with the present level of taxation, we are in danger of killing the goose which lays the egg.
Unless we are to halt the expansion of the Health Service and imperil the foundations on which it depends, we must adopt a third course. What we have to do, without reducing the hospital, family doctor and consultant service standards below the essential level, is to find some other source of revenue. Those words are not mine but those of the Leader of the Opposition in 1951. Therefore, my right hon. Friend has taken the course of increasing the contribution and the charges.
I completely support my right hon. Friend in this action. Equally, I appreciate the concern of hon. Members opposite on this subject. I fully appreciate—surely every one of us appreciates it—that to pay an increased contribution or an increased charge is not pleasant for anyone. Also, there is a certain validity in the charge that this is a regressive tax. Every flat-rate contribution is a regressive tax, and we must be cautious in shifting the burden from a graduated income tax to a flat-rate contribution. What we are proposing is no more a poll tax in the normal usage of the word than it was when it was introduced by hon. Members opposite. The contribution next July, when related to average earnings, will be almost identical with the contribution related to average earnings when it was introduced by hon. Members opposite in 1949. There is only a slight difference. In 1949 it was 3· 45 per cent. Next July, not taking into account any increase in earnings which might take place between now and July, it will be 3· 65 per cent. If this is an outrageous and insufferable poll tax today, why was it not an outrageous and insufferable poll tax when hon. Members opposite introduced it in 1949?

Mr. Ellis Smith: We did not support it.

Lord Balniel: My right hon. Friend has taken steps which will sustain the finances of the Health Service and ensure that it will be possible for us to continue its expansion. I sometimes wonder whether members of the public, particularly hon. Members opposite, have any idea how vitally and desperately necessary it is that there should be expansion and an increase of expenditure in the essential and critical parts of the Health Service.
Hon. Members opposite clamour about our proposals to deal with cod liver oil, which is free and of which only 9 per cent. of a possible uptake is used. They clamour about vitamin pills, which are free and of which only 30 per cent. of a possible uptake is used. Many years ago, when Florence Nightingale was nursing, the hospital beds were so close together that the lice used to pass from the bedboards of one bed to another. The beds were so close together that the nurses could not even change the bed linen.
Recently, I had the opportunity to visit a number of mental hospitals. Many of them were built more than a hundred years ago. Architecturally, they looked more like cavalry barracks than hospitals. Today, in the sixties, in one of them the beds were still so close together through overcrowding that there was not even room for a locker for the personal belongings of the patients. It did not really matter, because even if there had been room for lockers the hospital could not have afforded to buy them. In this hospital there was a female nurse establishment of 251. In fact, there were 120 female nurses in the hospital. There was a male nurse establishment of 190. In fact, there were only 102 male nurses. This hospital could not even advertise for more nurses, because it could not afford to build the accommodation for them.
It seems to me that it is these facets of the Health Service—the mental hospitals, staffing and new building—that we should emphasise, and we should not disperse our energies and resources on things which are less essential.

Mr. Steele: Mr. Steelerose ·

Lord Balniel: I have given way enough.
My right hon. Friend has embarked on a hospital building programme infinitely larger than anything which hon. Members opposite even dreamt of, and, far from placing his plans in jeopardy, as the proposals of hon. Members opposite would do, they should support him for his courage, his humanity and his wisdom.

7.9 p.m.

Miss Jennie Lee: We have listened to the hon. Member for Hertford (Lord Balniel) speak with great feeling about the conditions and hardships in hospitals in the days of Florence Nightingale. It would be interesting for us to know what the hon. Gentleman's forebears were doing about it at that time. If his family were following the true traditions of the Tory Party they would be taking very good care not to be dealing with contemporary hardships, although willing to indulge in historical reminiscences, about times when other people were working for improvements.

Lord Balniel: Perhaps I can answer the hon. Lady's question. My family were then members of the Liberal Party, but their descendants have seen the wisdom of the ways of the Conservative Party.

Mr. Peter Tapsell: Does the hon. Lady recall that the leading social reformer of the day was Lord Shaftesbury, a Conservative?

Miss Lee: I will answer both those interjections. I suspected that the hon. Member for Hertford was a throw-back. I am sorry to hear that he slipped even from the Liberal Party to the Tory Party. As for the intervention by the hon. Member for Nottingham, West (Mr. Tapsell), I have a great respect for Lord Shaftesbury. Every party throws up members with a vision ahead of their time and who are seldom appreciated by their contemporaries. The reason why Lord Shaftesbury's name is honoured is that he had compassion for the poor and he had the energy to follow up his sympathy. This marked him as different from the general run of his party. We on this side always honour brave men of vision. Lord Shaftesbury, therefore, can be claimed by us rather than by hon. Members opposite.
There has been considerable feeling in this debate and there will be more feeling before the night is over. The feeling that has been renewed today will continue during the remainder of the week, and after this week it will go on in broader, deeper and more passionate form. It is not as easy for hon. Members on this side as for hon. Members of the party opposite to get the true facts of any situation made widely known. We do not command the same publicity resources. Therefore, we have to fight very bard indeed when we set out to demolish the mountains of lies and half-truths with which they surround so many public issues.
I do not for one moment 'believe that if the people of this country understood the true facts about the Health Service more than a contemptible minority would support what the Minister of Health, with the backing of the Tory Cabinet, is proposing to do. It is our job, as always, to deal with a monumental barrage of lies and half truths, and to find our way to understanding as best we can.
During his speech, the Minister of Health said quite a few extraordinary things. But perhaps the most extraordinary of all was when he claimed that he and his party had been architects of the Health Service. I sent a note to the right hon. Member for Luton (Dr. Hill) and he has received it, but I can understand that it may not be possible for him to be present. I informed him that I intended to refer to him in the debate. If hon. Members wish to refresh their memories as to the manner and extent to which the party opposite co-operated in establishing the Health Service, they do not need even to fatigue themselves by reading the newspapers of those days. It would be enough if they looked at the accompanying cartoons.
It was almost impossible for what we on this side were trying to do to become known to the public because of the hysterical shouting and abuse that went on. We were told by the right hon. Member for Luton, who is now Chancellor of the Duchy of Lancaster and who at that time was doing a discreditable job in trying to prevent doctors from knowing the true facts about the Labour Government's proposals instead of assisting them, that if the Health Service was established there would be improper


interference between patient and doctor, that there would be bureaucratic control and that the wonderful work of the great army of voluntary workers in hospital administration, an army drawn from all parties and all classes, would no longer be wanted or at the least would be denigrated.
I am not complaining that in the newspapers of that time there was day after day both political and personal abuse. That is how the Tories fight. The Minister of Health is a man with a definite philosophy. He believes in his Toryism. It is to the good of the House of Commons if Members say plainly what they mean. I hope that before this battle is over, we on this side will show that we have an equally definite philosophy.
Do hon. Members remember what was said in those days by the British Medical Association? Today, even they are warning that if we continue to have prescription charges we are interfering improperly in the relations between doctor and patient. Does any hon. Member on the Government side deny that that is the contemporary opinion of British doctors? Doctors have now had experience of the Health Service. Again and again, they are put in an impossible position. Not only does the prescription charge mean that sometimes they have to prescribe much more medicine than is used. It means that they know that patients who would otherwise come to them sometimes stay away. It may be difficult for hon. Members opposite to realise the truth of this, but it is true. I have many other aspects on which I wish to speak and I will accordingly leave my hon. Friends to give further illustrations.
I am concerned with another improper interference in the relations between doctors and patients. It is intolerable when a doctor is dealing with a patient and the patient insists upon having a form of medicine which the doctor knows is two, three, four or five times more expensive than is needed, simply because it is a widely advertised proprietary brand. I do not think that the Minister or hon. Members opposite would deny this. Again and again, doctors are badgered by patients and by the relatives of patients. Especially

when people read in the venal commercial Press that those they love can be saved or that suffering can be reduced if only their doctor will prescribe these widely advertised drugs they press desperately to have them. We all know that that is true. Doctors not only deserve but need the protection of the House of Commons. The present situation should not be allowed to continue.
At the same time, doctors are badgered by the commercial advertisers. But it is the badgering by the patient which is much more difficult for the doctor to resist. Today we have been given illustration after illustration of the cruel commercialism, leading to inflated profits in the drug trade.
I now turn to my colleagues on these benches and I ask, what is the answer? The Minister of Health knows his Tory philosophy, but have we not a Socialist answer to this? Is it necessary that we should continue to allow the sale of medicine to be a lush field of commercial exploitation? Is it not time, particularly in face of what we have heard today, that we caught up with the needs of the time? Even enlightened Conservatives know what has to be done. A Tory doctor, writing in the Tory Daily Telegraph, has said that against all these pressures of commercial medicine, the only thing to do if we are to rescue patient, doctor and taxpayer is to have our medicines manufactured and distributed under proper conditions of public ownership and control.
I am not given to betting, but I am willing to predict that what I have now indicated will be the official policy of the Labour Party before long. And I hope that when I say so nobody will accuse me of trying to split my party. Everything we have to say in this debate today must be said in order to fulfil the great ideal of the Health Service, not to destroy it. And it can be fulfilled only by a powerful and united Labour movement. It will not be done by hon. Members opposite.
This House of Commons is a place of many changing moods. Its social urbanities do not change the fact that here great social battles are fought. I do not think that anyone, irrespective of party, would fail to help and sympathise with a fellow Member on a purely


personal issue. But that does not alter the fact that the British House of Commons is a battlefield: it is not a playpen, though hon. Members opposite would like to treat it as such. It is our privilege to be able to discuss and to settle great questions by Parliamentary methods that in less fortunate parts of the world have often to be settled by bloody murder, dictatorship and repression and social horrors of every kind such as I hope will never darken our fair country. But the alternative to violence is that we in this House of Commons should do our job effectively.
Hon. Members opposite often make seductive speeches. I have heard their tactics described as the iron fist in the velvet glove. I would be more inclined to describe it as a knuckleduster masquerading as costume jewellery. But you are not afraid to use the knuckleduster. You prefer the iron fist to have a velvet glove over it, but, nevertheless, you are willing to say to the people of this country in the year 1961 that you cannot come to the rescue of doctor, patient and taxpayer although you admit—

Mr. Speaker: I am sorry to interrupt the hon. Lady, but I must ask her to address her remarks to the Chair.

Miss Lee: I apologise, Mr. Speaker. I feel more benevolent towards you than towards hon. Members opposite and will leave you out of the battle.
In the situation we have now reached I do not see any solution to what is now happening in this field of medicine but to rescue it from the commercial interests that are behaving so shockingly at the present time.
Now I go on to a matter which my right hon. Friend the Member for Belper (Mr. G. Brown) dealt with extremely well in his speech. He anticipated the Minister of Health. He explained to the Minister of Health, in what I thought was extremely clear and cogent language, that because about 25 per cent. of the cost of the Health Service had been paid for other than by direct taxation when the Health Service was introduced, this was not a figure laid down for all eternity. I do not know whether the Minister has any need of an aural aid or not, but

certainly he had the point explained to him well and fully; all the same, he stuck to his notes, and came back again and again to the point that the percentage of the cost of the Service which was borne by insurance was right when it was started and was right at the present time. I do not so underestimate the intelligence of the Minister as to imagine that he cannot see the flaw in his own logic. Would he like to tell us that the rumour that the Government are going to rush to rescue 'the Surtax payers when the Budget is introduced has no foundation at all because the Surtax payers have to be kept at the point at which they were in the years 1949 and 1950 and 1951? Where is the logic of the Minister's brain?
I tell him further that he must not think that the impositon of this poll tax, the carrying of the cost of the Health Service on the insurance stamp, is part of the permanent philosophy of the Labour movement. It most certainly is not. We, like you, Sir, have deep roots. We, like you, Sir, have a philosophy. Our philosophy, Mr. Speaker, is that the way to deal with such issues is from each according to his means, and to each according to his needs. I hope that hon. Members opposite will not think that this is old-fashioned language, because the only people who can effectively deal with the future are the old-fashioned ones, that is, those with roots deep in the past. It is a very basic part of the philosophy of our movement that we should give according to our means and receive according to our needs.
Instead of being badgered about with all this nonsensical talk about what percentage of the cost of the scheme should be borne by the insurance stamp, lest us make the conflict between the two sides of the House, clear to the whole world outside, particularly the industrial population. Let us join issue as the battle develops, and say quite clearly that the whole of the cost of the Health Service must be paid for by the Chancellor of the Exchequer.
I hope that when we reach that point—because I am certain we shall reach it—we shall at the same time make it quite clear that we do not have a free Health Service. We can no more have a free Health Service than we can have a free Defence Service—but nobody would think of paying for the Defence


Services of Great Britain by adding to the poll tax taken out of the wage packet of the ordinary worker.
We have got to raise our banners higher than they were in the past. Times move on. We have got to be careful that we do not become infected by the political disease of hon. Members opposite, Conservatism. We have to be looking ahead, and I say that the way to get out of this continual, frittering argument is to lay down the clear lines of division between the two sides of the House. It is nonsense for a country like Great Britain to pretend that it cannot meet the whole cost of the Health Service without resorting to charges on spectacles, teeth, surgical instruments, prescription charges and insurance impositions.
The Minister of Health has his head in his hands. Maybe he is counting. I have been counting, too, and I know perfectly well that the Service is costing us about 4 per cent. of the national income. There has been some small difference in the figures quoted. Some of us got them today from the Library, some of us got them elsewhere. When I say that the whole cost has to be paid for in that way I know it would be a substantial increase, but I also know that there are means by which we can not only increase national expenditure but can make very considerable national savings.
There has always been a dual morality in public life. We have one standard when dealing with expenditure on social services and another when dealing with expenditure on armaments. I am no pacifist, and I am the last person in this House who would resort to what I would consider the most unfair demagogy of pitting defence against the National Health Service. Two of the supreme responsibilities of any Government are fairly to defend our country and fairly to see that they sustain, at the highest possible level, the health of our people. But I fail to make sense of one investigation after another into charges on our Defence Services.
The Estimates Committee was meeting quite recently. I believe it was considering the Sea Slug—I am open to correction about details. That is not my line of country. But the essential

consideration that emerges—and this concerns every taxpayer—is that again and again we are told that Ministers have made estimates for military equipment fantastically wide of the mark. The Sea Slug was to cost £1 million. Yet before we know where we are we find that it costs £70.
Then there is the kind of inhibition which the Government have when dealing with the subject of equipping and provisioning the Defence Services. I hold the view that we on this side of the House should become as tough businessmen and women as Members opposite claim to be. We should realise to the full the advantages we have in buying for Government Departments. Whether we are buying for the Defence Services or for the National Health Service we are customers with a very large order. Whether we are bidding for beds, for hospital equipment, for medical instruments, or for anything else, we should exact, in a way that we have not even begun to do, all the advantages of our position. Sometimes we could save money by astute buying, by mass purchases. Sometimes we could do it by insisting that the particular product must be nationally owned and produced.
I give one example only from the early days of the National Health Service. Aneurin Bevan was very proud indeed—and remember that he was the Minister responsible for housing as well as for health—when, on top of all his other duties, he could come to the rescue of thousands of deaf people in this country.
The wonderful way in which he did so was by reducing the cost of all aural aids to almost one-tenth of what they had been before. The reduction was spectacular. The duty of Ministers who have followed him is to keep on improving the type of aural aid and, at the same time, to keep on exacting the maximum advantages which they have because they are such great customers.
I do not want to see the provisions for the National Health Service and for the defence services in conflict with one another. We have to resolve the question of priorities. Some of us hold that the language of priorities is the religion of Socialism. Hon. Members opposite may not yet know what that means. I hope that in time we shall teach them what it means. It means that there are always


things which a nation cannot afford, but that the test of civilisation of that nation lies in how it decides its priorities—what it can afford and what it cannot afford.
It is a disgrace to all of us, when we look round our country in the last year or so—and particularly when we look round the West Ends of our great cities—and see the blatant expenditure which tells us, by the naked eye, that there are some in our community who are taking full advantage of Tory Government to extract not coppers from the Exchequer, not small sums, but millions and tens of millions, and even hundreds of millions of pounds for their own consumption.
It is time for me to end my speech, but I want to mention one thing more—and it is something which cuts very deep with me. I am not given, as the Press knows, to discussing private matters. I consider that private life is private and public life is public. I consider that people in public life who are willing to be exhibitionists as far as their families and private firesides are concerned, are two-dimensional types. If they cannot protect their own homes they are not going to be much good in protecting others. That is the philosophy which I follow. Some hon. Members on both sides of the House will agree with it. and others will disagree with it.
When I beard the Minister of Health boast, in the introductory passages of his speech, about what he was going to do to increase hospital accommodation in the next ten years, I was almost physically sick. My dismay was because, instead of boasting about what he has not yet done, he should have been apologising to the House for what he and his predecessors have failed to do in the last ten years.
It is a very poor defence indeed, having allowed our hospitals to go unrenovated and under-staffed, with their nurses underpaid, and having failed to provide new hospitals that should have been begun a decade ago, to tell us what he is going to do in the future.
I had a dilemma to face which many citizens of this country are also facing. My mother is 82 years of age. She was fortunate enough to have a cataract cut from one eye, which made a great difference to her life. She had the operation as a National Health Service patient, and it was done with superb skill and kindness in every way

Then she became obsessional about the other eye, which still has a cataract on it. She felt that the bad eye was affecting her good eye. She was not able to read. I was faced with the problem of what to do about it. I have a wonderful doctor, and he did everything in his power to get her back into hospital to have the second cataract cut. He used the perfectly fair argument that this was now a nervous condition as well as a physical one. He did everything in his power. We raked the local hospitals which would have been capable of doing the operation. At the end of the day I was told that my mother, after all the agony she had gone through, had to face the winter as she was. My doctor was not able to tell me when she could have her sight restored.
I have all the documents. If they had told me that it would be a week, a month, two months, I would have waited. But at Moorfields Hospital—a superb hospital—the waiting list at that time was 1,700. We raked all the hospitals in our area. It was the same story wherever we went. I could not be given a date, and so I had to face the problem of what to do.
I made the decision of which I am now going to tell the House. There was only one thing to be done: she must have that second cataract cut. She had had as much punishment as any wonderful mother ought to be asked to take. She had the cataract cut in the same hospital where she had had the first cataract cut. Once again a superb job was done, but she had it cut because I was able to sign a cheque for a certain sum of money.
It is disgraceful that any daughter in this land should be put in such a position. I do not for a moment imagine that I am the only one with a profound love for her mother. Aneurin Bevan would have pulled down the heavens rather than have her suffer. I wonder how the hon. Member for Hertford would have dealt with a situation like that. I wonder if he would have cared, as I care deeply, that any other daughter should have that dilemma facing her, that she be expected to watch unnecessary suffering at the heart of her home because she cannot afford to sign a cheque for £50 or £100.
Since I have embarked on the story, if the House will forgive me, I had better


give the rest. As a private patient, my mother was in a little room on her own. I explained that it would be much better if she went into a general ward. She wanted to be in a general ward. Her memory fails her and I thought that she would have been less frightened in a general ward. I suggested that even though I would pay, someone in the general ward, with a different temperament and badly wanting privacy, should change over with my mother, so that my mother would go to the general ward which suited her temperament so much better. It could not be done. I am not blaming anybody. Doctors in hospitals have to work to regulations and I hope that not a single word of mine will be taken to reflect on nurses or doctors or anyone else in hospitals, because they could not be more skilled or kinder.
The next thing that happened was that I was told that my mother had got up in the middle of the night and would now have to have a special night nurse. In the private wing of that hospital there were only two night sisters, so there could not be one always available for one patient. Could there be a greater waste of our resources? If my mother had been in the public ward she would not have needed a special sister. I resented that waste. But supposing that I had just managed and no more to scrape up enough to get my mother into the hospital as a private patient and had then found that I had to pay other bills for special night nursing! That is a dilemma which faces many people. Of course, I said that whatever was necessary for her safety and protection was to be supplied.
I hope that hon. Members opposite will not under-estimate how deeply these issues affect hon. Members on this side of the House. It must be remembered that the National Health Service was started against monumental opposition. To get it started required great courage, great compassion, an iron will and very great administrative ability. With all those qualities, to get it started at all inevitably meant that compromises had to be made. But compromises which were forced on us by the circumstances of the immediate post-war years are intolerable in the circumstances of 1961.
I hope that my hon. Friends on these benches will not be afraid to hold high the banners behind which we march. Hon. Members opposite can twist the figures any way they like, but the fact is that we might at this moment have the pleasure of perfecting our Health Service. Instead, we are engaged in this squalid debate about raising prescription charges from 1s. to 2s., and so on, and about who was responsible in 1950 and 1951. I could tell hon. Members the whole of that story. I can relate its every nuance, but I am interested in rallying not only my own colleagues, whom I know to be entirely at one with me on this issue, but the common sense and the common kindness of the people of this country, in particular the great army of voluntary health workers who make it possible for the administrative cost of the Service to be little more than 2 per cent. There is an immense amount of good will for the Service.
Do not let us appeal to the lowest in our people. We can no longer give world leadership in terms of wealth or size. But some of us hold firmly to the belief that we can still give another leadership because of a quality of tenderness and mercy in our people. This we can do if there is true family feeling among us and provided we are willing to work and live by civilised priorities.

7.46 p.m.

Mr. James Dance: I will not attempt to follow the arguments of the hon. Lady the Member for Cannock (Miss Lee), but I know that I speak for both sides of the House in expressing sympathy for the difficult time which she has had in dealing with her mother and in getting her into a hospital.
However, the accusations which she made against my right hon. Friend were not fair. There are several hospitals in my constituency, and I have seen the work which is being done to modernise them. As a result, some of them are now extremely good, and also there are great schemes for building new hospitals. Since the war, much work has been done to convert some of our older hospitals into better places for the treatment of patients.
With one proviso, I welcome my right hon. Friend's proposals and congratulate


him on his courage in bringing them forward. Hon. Members opposite keep condemning us for undermining the National Health Service, but far from undermining we are strengthening it by the action we are taking. It was hon. Members opposite who attempted to undermine the Service when they put on the £400 million ceiling. I am glad that the Leader of the Opposition, who is not here this evening, sometimes shows a little more sense of reality than do his colleagues. He proposed prescription charges and, had the Labour Party returned to power, would have brought them in.
The hon. Lady the Member for Cannock said that the Health Service was not free. How right she was. The Service costs are well above £800 million a year, but some hon. Members opposite have a different philosophy, which I fail to understand, that if anything is free it must be good, while if it has to be paid for it is automatically bad. Obviously, the sum of £800 million has to be paid; we differ in our methods about its payment.
I now come to the proviso which I have mentioned. There may be a certain section of the public who will be penalised or even suffer hardship because of these additional charges. I am referring to the borderline cases who are not actually receiving National Assistance. I know that it is extremely difficult to get a formula to help these people, but I sincerely hope that my right hon. Friend, in consultation with the Chancellor of the Exchequer, will attempt to find some formula to solve this problem.
Under a Tory Chancellor, under the 1957 Finance Bill, the principle of making a concession was introduced. In 1958—and I have the actual Memorandum which was sent out—the allowance was raised. Those who had incomes not exceeding £275 were exempt, provided they were 65, and for a married man it went up to about £440. I do not say that that is the solution, but this bracket group might possibly be the basis for some formula.
I feel that in the whole realm of National Health Insurance we are apt to forget the operative word "insurance". What is insurance? It is a system whereby many contribute some money to a fund, and when one falls on hard times one can draw from it.
If I may digress, how did insurance start? A man named Lloyd had a coffee house in the City to which sea captains and owners of ships used to come and discuss their problems. On one occasion, one of these owners lost three ships rather rapidly, and the others clubbed together to help him out of a difficulty. They then said: "This might happen to us all. Why do not we all contribute and make a payment in case a disaster comes upon one of us?" That is how insurance started.
I do not believe that it is right to think on the lines on which I am afraid so many people do, not only for Health Insurance but all insurance. The present trend is to say, "If I pay in £10 a year I am getting a bad bargain if I do not take out £11". A lot of people believe that. The real truth of the matter is that we all subscribe and we do not want to take out little fiddling amounts. What we want to do is to ensure against real disaster and trouble.
I was recently in Canada and I was told the story of a young girl who worked in a bank. She absconded with 10 thousand dollars. She was brought back for trial and was asked: "Where is the money? What did you do with it?" She produced receipted bills for 11 thousand dollars for medical treatment for her mother. That is a large sum of money. Thank God, that sort of thing cannot happen here. Thank God, we have this Health Service.

Mr. George Thomas: Does the hon. Gentleman believe that people without money can now get a service equal to that which the wealthiest in the land can get? Does he believe that now?

Mr. Dance: I do indeed.

Miss Lee: After what I have said?

Mr. Dance: Anybody who is seriously ill can get the finest treatment the country can provide. There is no question about that.
I believe that there is much waste in our Health Service. I know of many cases where people who go in for regular treatment, it may be for their eyes or for their hands, or for something like that, who could quite easily travel by


ordinary transport and, if necessary, have their bus fares refunded. I know of ambulances—I am not now referring to large ambulances for stretcher cases but to ambulances for sitting cases—travelling fifteen or twenty miles to bring people in for treatment. Not only is this a waste of money, but the time the patients spend away from home or away from their jobs is a waste. I believe that that should be looked into.
There is another side, and I am referring now to prescriptions. Far from condemning all doctors, I believe that there are quite a few doctors who are a little lax in the way in which they prescribe. I know of an American who stayed at the Dorchester. He cannot have been broke to have stayed there. He was going back to America on the "Queen Mary" the following day. He cannot have been hard up to have done that. He suffered from asthma. He wanted a drug—I think it was called antihistamine. He went to a chemist and asked for two or three tablets. The chemist said, "I am sorry but this is on prescription in this country, although I know that you can get it without a prescription in America". The American asked what he should do and was told by the chemist, "The only thing I can do is to give you the address of a doctor who will give you the prescription". The American went to the doctor and then returned to the chemist twenty minutes later with a prescription for one hundred tablets, yet he needed only two or three, or perhaps four. The cost of that prescription was 42s.

Dr, Stress: Dr, Stressrose —

Mr. Dance: I will give way in a moment.
I know of another case of a woman who had a thorn in her finger. She received treatment in the out-patient department and was told to keep the finger clean and wrapped up. She was given a prescription for twelve one-inch bandages. Surely that is wrong.

Dr. Stross: As regards the first story about the American who stayed at the Dorchester and had to see a doctor and was given a prescription for antihistamine, did the American pay the doctor a fee before he consulted him, and what sort of prescription was it? Was it on Form E.G.10, or on a private piece of

paper with a prescription for which the American paid?

Mr. Dance: I do not know whether it was Form E.C.10 or Form E.C.11, but it was not on a private piece of paper and it counted against the National Health Service. He did not pay one penny for it. He was not a resident here; he was merely passing through.
Finally, there was the case of the man who went to a doctor and was given a prescription for one hundred tablets of terramycin. I gather that this is an antibiotic. He took it to a chemist who gave him his tablets. He was surprised at the quantity because I understand that this is a form of shock treatment which produces effects in two or three days. The chemist thought that this large quantity was unnecessary.
Some days later the patient went back to the chemist and said that as he was feeling rotten he had given up taking the tablets. He asked whether the chemist could recommend a good tonic, and on the chemist's recommendation he bought one. Later he went back to the doctor who said, "You are looking very well now. You had better have another hundred terramycin tablets". He received in all two hundred tablets. Only two days ago I checked the cost of those tablets and found that it was 174s. 2d. per hundred.
I have referred to those cases because I consider that they are glaring examples of what can happen, but if cases like that occur there may be many others. I feel that some instruction might be given to doctors to be a little more careful in how they prescribe. Let me add that I am not accusing all doctors of prescribing indiscriminately.
I believe that we have the finest Health Service in the world. It is the envy of the world. Not only have we now an excellent Health Service, but I believe that the measures put forward by my right hon. Friend will see that we maintain that Health Service not only now but also in the forseeable future.

8.0 p.m.

Mr. Arthur Holt: I understand that it is not the intention to call the Amendment in the names of my hon. Friend the Member for Orkney and Shetland (Mr. Grimond), other hon.


Friends of mine and myself, to leave out from "indicates" to the end and to add:
the failure of Her Majesty's Government to put forward any new proposals for the financing of the National Health Service which would be equitable, would ensure economy and would allow for the proper development of the service".
But I do not think that my remarks will be in any way out of order, although they are largely directed to the points made in the Amendment—because the debate has ranged very widely.
As compared with what went before it, and even compared with what people had in mind when it started, the National Health Service is undoubtedly a very fine one. But there is a great deal still to be done, as was indicated by the story told by the hon. Member for Cannock (Miss Lee). We must avoid this Service becoming a kind of sacred cow, so that when a Member criticises any aspect of it, or the way in which it is run or financed, he is immediately accused of being opposed to the idea of a National Health Service which is freely available, in the sense that any person who needs it can take advantage of it without let or hindrance.
The fact that it is going so well considering how it started—and the hon. Member for Ludlow (Mr. More) and the hon. Member for Hertford (Lord Balniel) had something to say about the way in which it started—makes it all the more necessary to view it with a critical eye and ensure that it develops properly, as circumstances require. It is not a free service; it never has been. It has to be paid for, and the real argument arises as to how it shall be paid for. I have yet to hear a convincing argument to prove that the Service can truly serve the needs of all the people only if no charges are made upon a person when he wishes to take advantage of any part of it. I am not against charges; the question is what should those charges be, and what will their effect be on the general purpose and usefulness of the Service. I am opposed to charges whose sole purpose is to ensure not the better use of limited resources—and some are still very limited—dut the finding of some way of raising more money for the Exchequer.
I find it difficult to differentiate between a charge borne by the

Exchequer, which is regarded as being paid by the taxpayers, and a charge which is suddenly imposed, for example, by an increase in the price of the prescription stamp. That is also a tax, in another form, and I do not see how the Minister has achieved any miraculous saving of the taxpayer's money by suddenly putting 1s. extra on the stamp. Perhaps the Parliamentary Secretary will enlarge on that point. The person who pays the contribution for the stamp is a taxpayer, and all that has happened is a movement of the kind one might expect in a Budger—which might be right or wrong—from a tax on the generality of taxpayers, in a progressive fashion, to a poll tax. As I see it, the services should be available to all, and no one should be prevented or even discouraged from making a proper use of them simply owing to lack of means. Such financial disciplines or checks as are desirable should encourage preventive medicine in particular and the best use of resources in general.
I want to examine some of the increases against that background. I agree that it seems difficulty to understand why the increases have been put on welfare foods, especially on orange juice, which has been increasingly used in recent years, but there is not a very wide use of the three welfare foods, taken together. The probable truth is that it is not so much that parents are neglecting to use them as that they are buying other proprietary forms. A case can probably be made out that it is no longer a proper use of our economic resources to continue this subsidy in respect of foods which are not being widely used, especially in the case of cod liver oil.
The correctness of the provision with regard to amenity beds has been questioned for a long time. Even with the increased charge of 24s. this is still an uncovenanted benefit to those who make use of it. In view of the existing pressure on beds I would have thought there was a good case for charging either their full cost, or alternatively, adding them to the rest of the beds for general use in the hospitals. In that case the lady referred to by the hon. Member for Cannock could have made use of the amenity bed.
If a charge is made on spectacles it tends to ensure care in their use, and


their preservation, but I would have thought that the present charge was sufficient for that purpose. I do not see what extra benefit is to be derived from the increased charge, apart from the fact that it will bring in more money to the Chancellor. The same can be said of the increased charge for dentures.
The case for a charge on prescriptions has never successfully been made out. It was not successfully made when the charge was first imposed, and I have heard nothing in the last few days to convince me that the case is any better now. Whatever provision may be made, the Minister knows that there are many people who will not take advantage of these arrangements because they are either too proud to apply for National Assistance or they do not know about it or understand it. The arrangements are too complicated and people in the lower-income groups are often the people who least understand them, although they are often made for the good of those very people.
Doctors have assured me that quite a number of their patients will suffer hardship as a result of this increase. The sympathetic doctor will prescribe larger quantities of medicines than perhaps would otherwise be the case. That will defeat the Minister's purpose, because in that way he will lose prescription charges and it will increase waste and, therefore, the total charge for the drug bill which the Chancellor of the Exchequer will have to find. It will certainly add to the burdens and debts of country doctors, as did the original charge.
So far as I can see, all that will be achieved by this charge is that money will be brought into the Exchequer. It does not achieve what I should like to see, a true economy in the Health Service. If economy is the aim—that is an important aim at any time—while avoiding hardship, I suggest that there are two alternatives which, at least, are worth considering. The first is that drugs should be free to low-income groups to a greater extent than was indicated by the Minister, and that for the remainder, those people who would not come within the ambit of the groups, there should be not a flat charge of 2s. but a percentage charge. This would ensure that a person paying 2s., 3s., 4s., 5s. or 6s. for a drug would see

that the prescription was not made out for a larger quantity than he required. A percentage charge would go some way to achieving this, whereas a flat-rate charge would not. I should not recommend a minimum limit for such a charge, but there could be a maximum of 10s.

Mr. G. Thomas: The hon. Gentleman is propounding on behalf of the Liberal Party the idea of a means test on a bottle of medicine. How would he apply it and decide who should pay the maximum?

Mr. Holt: I agree that that would be a complex matter.
The Minister has already indicated his own proposals about the raising of the limit to those who are in a higher group than the National Assistance limit, and I do not see why arrangements cannot be made for a much higher level. I wish to get right away from the possibility of anyone suffering hardship in this matter. The handling of prescriptions and the payment would not present any difficulty.
The prescriptions could be priced and the amount marked on the prescription when it was paid so that there would not be any possibility of a "fiddle" by the chemist.
The whole point of my argument is that I feel it important that we should get out of the entrenched positions in which apparently no suggestion about alterations will be acceptable, at any rate by the Labour Party, and nothing can be considered which is in any way a charge when medicine is purchased or at the time of sickness. That is a perfectly reasonable point of view to be adopted by people who believe it to be absolutely essential that no such charge be made. I do not believe it is. I consider that, in the years to come, such a system will not provide us with the best Health Service for the country as a whole, including the poorest of our people. Therefore, I think we should have a free discussion of different forms of charge which we could consider imposing.
The other alternative I wish to suggest is that the vast majority of prescriptions could be made from the British National Formulary and such prescriptions should be free. I am told by doctors that there would be no difficulty about this. The Formulary is brought up-to-date every year. There might be a comparatively small number of drugs that a doctor


might want to use which might not be included in the Formulary but special provision could be made for that. The drugs from the British National Formulary should be free and there should be a full charge for proprietary brands if patients decided that they would sooner have some branded product instead. One could give an example of this by quoting the case of aspirin. The standard soluble aspirin which I think is called acetyl-salicylic acid costs 8s. 1d. for 500 tablets whereas "Solprin", which is frequently prescribed, costs 12s. 6d. for 500 tablets, that is 50 per cent. more than the standard aspirin, and I am assured that it does no one any more good.
If the British National Formulary were used as a basis, and the prescriptions were free, and if anyone wanted a proprietary brand they would have to pay the full price, that would seem to me to introduce a real element of economy in the use of drugs. It would cope with all the kind of nonsense with which doctors are inundated every day. I am told that articles such as I have in my hand are put through their letter boxes at the rate of 10 or 12 a day. This one is a long-playing gramophone record all about diabetes. I asked the doctor who received it if he knew about diabetes and he said he did. A tremendous lot of money is being wasted on this sort of thing and, by this means, great pressure is brought on doctors. Not only are they the recipients of this kind of glamorous and interesting literature but they also receive invitations to lunch or to see film extracts. It is only natural that sometimes they should feel an obligation to the people who entertain them so well.
My complaint against the Minister is that he has not given any new thought to the financial development of the National Health Service. There has been no hint, for instance, of any major tax reform coming from the Government recently.
In this connection, it is time that we thought again about a social security tax. Running the dual system of stamps and Income Tax is long out-dated. The Royal Commission went into the question of a social security tax, but did not examine all the possibilities. I should like to see more study made of a progressive form of social security tax which would cover the whole cost of all the

welfare services of the State. While there has been no particular zeal in pursuing tax reform, there has been talk in other quarters about a move away from Income Tax to direct taxation.
The Minister has not shown a real inclination to study the financial disincentives to the right development of the Service in other fields. I particularly mention the domiciliary services. In his speech the right hon. Gentleman referred to the one-third increase in domiciliary consultative services and to the need to strengthen the midwifery service. He. went on to say that the new hospital building programme—I think his words were—spells out the appropriate development of the local authority health service. I take his point on this, because I have spent a great deal of time in the last few days considering this matter. It has struck me that the development of the domiciliary services appears to be an entirely logical, proper and very humane development.
I was most interested in a programme I saw on television two or three weeks ago. Other hon. Members may have seen it. I think it was about the domiciliary service in Croydon. I found it most impressive. In Bolton, my home town, expenditure on the local health services in the last ten years has more than doubled. There is a tendency, however, on the part of local authorities—which originally got a 50 per cent. grant towards local health services and now do not know what they get, because it is hidden in the block grant—whenever a suggestion for further development is made, to say, for instance of the nursing services, "We pay half this. We had better encourage people to go to hospital."
It would appear that as new hospitals are built they will concentrate more and more on very highly specialised services. The new drugs have given the general practitioner greater ability to deal effectively and quickly with many more diseases of patients at home rather than sending them to hospital. This seems entirely desirable, but it is dependent upon a further growth of the domiciliary services and good co-ordination between the general practitioner and those services, and an increase in the morale and status of the general practitioner, whose status had seemed to be going down.


If we look at the financing of all this we see that everything is loaded against this development. The medical practitioner gets a per capita fee. His inclination, if he is governed only by monetary interest, would be to write out a chit and get the person to hospital as quickly as possible, and not to say, "I will visit you at home and will pay you several visits." The local authority, because it bears half the cost, has the same inclination to say, "Let the hospital service do the job."
I come to another point, which no doubt will appear slightly controversial to the Labour Party. That is the question of the cost to the patient when looked after at home, as distinct from when he is in hospital. I am not in favour of making a house charge for patients in hospitals as such, but, when we look at that proposal in connection with the development of the domiciliary services, in equity there starts to appear a very good reason why at least careful consideration should be given to whether those who can afford it should pay something towards that accommodation.

Mr. G. Thomas: Oh.

Mr. Holt: The hon. Member may say "Oh", but, if someone stays at home to be looked after by a visiting G.P., not only may he have to pay something for domestic help, but someone in the family may have to stay at home from work to help to look after him. That is a very great charge on the family and the tendency has been to say, "Go to hospital where everything is free." If we accept that the development of the domiciliary services is a desirable development within the limitations, this point is at least to be considered.
The answer one might give is that, in that case, we should increase grants for people who stay at home when they are ill. My point is that the present financial arrangements are weighted against the domiciliary services. It is greatly to the credit of all those who have been involved in those services that, in spite of this, the services have made such great headway. It is to these and kindred subjects that the Minister would do well to pay attention in future.

8.28 p.m.

Miss Joan Vickers: I am glad of the oppor-

tunity to follow the hon. Member for Bolton, West (Mr. Holt) and, in particular, to refer to the last point which he made about domiciliary work. I agree that, whenever possible, people should be nursed in their homes, but I point out that it is possible to obtain adequate home help from local authority or voluntary sources. These services should be increased, but there need be no fear that they will cost the family anything. The services are available to provide the help which is needed.
The right hon. Member for Belper (Mr. G. Brown) likened my right hon. Friend to a quantity surveyor. I think that that was a great compliment, because no architect of any scheme would dream of going ahead without the views of his quantity surveyor. An architect may have many airy-fairy ideas, but it is the quantity surveyor who knows the practicalities of the job. The right hon. Gentleman could therefore have paid the Minister no greater compliment than to suggest that he is a quantity surveyor. My right hon. Friend will now get down to the job. Perhaps we should have had a quantity surveyor many years ago.
I have lived in a number of countries, and I consider that our Health Service is the most comprehensive in the world. I can prove my point by reference to the services in other countries. In Australia and New Zealand, for instance, one has to pay when one goes to a doctor. One pays for one's medicine and receives back a percentage of the payment, perhaps 80 per cent. With the exception of pensioners and those needing life-giving drugs, the people pay for the services of the doctor and for the medicine. I think hon. Members will find that in Britain we have the most comprehensive, all-over service. A number of countries rely on health insurance. America, for instance, has the Blue Cards and the Blue Shield schemes. If hon. Members go to other countries and see how the people's health is catered for, I think they will agree that the poorest people in this country have better protection than the poorest people in any other country.
A United Nations Study on Drug Costs in twelve prosperous countries, published in 1959, shows that expenditure in Britain, expressed as a percentage of the average income, is


lower than in all but two of those countries, although the patients bear a far larger share of the cost in all the other countries. I think that is another proof of the value of the Health Service. I am sure we were all interested that President Kennedy referred particularly to the service in this country, and many of us were astonished that one of his first acts to relieve the poor was to increase their food parcels, things about which we have forgotten in this country for thirty years.
In my opinion, the functions of the Health Service are to keep the people fit and to continue research into those diseases which are not already conquered. The Health Service has done a tremendous amount to conquer tuberculosis and poliomyelitis. Recently, the increased assistance to mental health work in this country has meant that we lead the world in attention to mental health. We have more people employed in the country than ever before in our history, and that could not be the case unless they were fit, and physically and mentally strong. That is another way of proving that the service is working well.
I think that we have the healthiest children in the world. The children of today are much heavier and taller than those of ten years ago. When hon. Members talk about the health foods no longer being provided free, we might consider that this is not necessarily detrimental, in view of the figures which have been given during the debate of the lack of interest in these foods. I have a cutting here which some hon. Members have seen, of a letter in the Sunday Express which, referring to cod liver oil, says,
I give it to the dogs.
When hon. Members opposite talk about orange juice, perhaps I have an unsympathetic mind, but I recall that orange juice goes very well with some other types of drink, and if it is free there is a great temptation to use it in this way.

Mrs. Harriet Slater: This kind of thing is not good enough. It is the kind of thing we have heard for years. If the hon. Lady cares to read the Conservative Party's latest glossy pamphlet, she will see again this suggestion that we should have a means

test because some people mis-spend what they have. Let us judge on the majority and not on the isolated cases which are are quoted in letters in the Sunday Express.

Miss Vickers: I agree that we should always judge on the majority, but it is right to point out that there are abuses of certain services and that it is necessary to take them into consideration when we make these changes.
The increase in the average length of life in Britain is a great credit to the service. In India the average is only about 32 years, but the average length of life here is increasing year by year. This is partly because of the Health Service. [HON. MEMBERS: "Hear, hear."] Exactly. I am trying to show you how it is working.

Mr. Deputy-Speaker (Major Sir William Anstruther-Gray): It would be better if the debate was conducted through the Chair.

Miss Vickers: I return to the question of the working of the National Health Service. It works on three prongs—through hospitals and the specialists, through local authorities, and through general practitioners. There should be much more co-operation between those three branches.
The Minister has announced the rebuilding programme for hospitals. We are all very pleased that it is beginning. In the rebuilding scheme, hospitals should be built more on the lines of present-day schools. Many hospitals built in the 1880's are still in operation. They were so strongly built that it will cost a tremendous amount of money to pull them down. In the changing pattern of the Health Service, I should prefer to see less permanent buildings so that we can keep up to date as the years go by.
Some of the hospital regions are still too large. A region in the West Country spreads from Gloucester to the Scilly Isles. I understand that a new group was recently created in Wessex. In order to have easier working of the scheme, some regions should be looked at carefully with a view to being cut down.
I realise that the hospital building programme may take a long time. I will therefore suggest some action which my


right hon. Friend can take at once. I should like to see a team of surgeons, doctors and nurses formed to deal with what is called "cold surgery". I mean the type of case to which the hon. Lady the Member for Cannock (Miss Lee) referred, which is not a priority because it is not an emergency. There are a number of tuberculosis hospitals which are hardly being used. Many of them have good theatres. Where possible, as it would be in a number of districts, I should like teams to be set up to go round performing operations—cold surgery—to relieve the very long waiting lists of hernias, varicose veins, etc., which prevent people doing a full day's work. If this was done, the waiting lists would be cut down considerably.
I should like to see local authorities taking charge of all the chronic sick and the ambulant old. I should like to see hospitals used for acute cases. The division of authority at the moment makes for poor working. I quite agree that the block grant would have to be increased. I hope that there will be a gradual process of making aged patients, whether they be bedridden or ambulant, the responsibility of local authorities.
The number of out-patients has increased by 12 per cent. since 1949. We could do much to build up the status of general practitioners. One hon. Member said that it is very difficult for a doctor to refuse to give certain drugs if his patient demands them. It is equally difficult for a general practitioner to refuse to send a patient to a specialist if the patient demands it. Very often, the general practitioner is equally capable of doing the job. Doctors receive ten years' training, but they are perhaps not getting the benefit of that training in the eyes of the general public. I should like to see general practitioners given a better status in the country.
Turning to prescription charges—

Mr. G. Thomas: The hon. Lady has been dealing with the Health Service and with improvements in the hospitals. Will she defend the Minister in all his increased charges?

Miss Vickers: I have been trying to show how good the various branches of

the Health Service now are in many ways, and seeking to prove that they have not been undermined, as the Opposition's Motion alleges. I have been using these illustrations to make my point that the National Health Service has been doing its duty to the people, and that, under the propositions now put forward by my right hon. Friend, we can expect it to be even better in the future.
I want to refer to prescription charges because, as many hon. Members know, I was one of those who did not vote in favour of the last increase in them. My right hon. Friend has said that people on National Assistance—old-age pensioners and others proving hardship—can either get the money for the prescription prior to receipt of the medicine or can claim it afterwards. For the future, I should very much like to obviate this rather lengthy business. which often entails much travelling.
I suggest that a special form should be given to doctors, who would enter only the name and number of the patient who is in receipt of National Assistance. The patient would then take the form directly to the chemist and get the medicines, leaving it to the chemist to make the claim. That would save these people having to hand out the money in the first place, and I hope that that suggestion will be considered.
I should like to suggest, also, that these charges should not be increased until 1st April, instead of 1st March, as they would then coincide with the increases in pensions.
I hope that in future it will not be necessary continually to increase the National Health contributions and the prescription charges. I should like to see for the lower-paid workers a sliding scale on the same lines as we have for National Insurance. I think that it was the hon. Lady the Member for Lanarkshire, North (Miss Herbison), who said that people earning £9 a week and under would soon be paying lower contributions for their pensions but that we were now asking them to pay considerably more for their National Health Service benefits. We talk a great deal about the average wage being £14 a week, but averages do not mean much, and I know of many people who have £10 or less. That being so, the same consideration as


is given in the administration of Income Tax and National Insurance should be given to those in the very low income groups.
I want to pay a tribute to the very many voluntary organisations that do such great work in our hospitals. I think of such organisations as the League of Friends, whose members not only help greatly in the way of visiting patients and the like but contribute considerable sums of money for improvements to the hospitals themselves. Such action shows that although this is now a national service, individuals still take a great deal of interest in it, and wish to add their share for the benefit of the patients.
Tribute should also be paid to the many students from overseas who nurse in our hospitals. Many hospitals would be short-staffed without them, and by the training we provide here we increase the service we can give to the newly-developing countries. In conclusion, I wish my right hon. Friend success in his new scheme, and in his term of office as Minister of Health.

8.44 p.m.

Dr. J. Dickson Mabon: I think that if the hon. Lady, the Member for Plymouth, Devonport (Miss Vickers) wanted to give a title to her speech she would probably call it "The Painful Consequences of Mr. Powell", because she, at least, has shown some compassion for those who will be hard hit by these increased charges, and has made a gesture of anguish on their behalf, which is more than we can say for the majority of hon. Members opposite.
I am sorry that the hon. Member for Carlisle (Dr. D. Johnson), who is a professional colleague of mine, is not in his place. He was the man who challenged my right hon. Friend to a debate in Carlisle. I should like to attend this debate and to see him wiped across the floor as he was wiped across the floor from 1945 to 1949 when he fought tooth and nail against the Health Service up and down the country long before he ever came to Parliament. It is true that he fought against the Health Service 100 per cent. and, even now in his own writings and, for example, in his recent book "Doctor in Parliament" he still puts on record his objection to the National Health Service in principle. He is an honest man, even

though he is so dreadfully lost in the present-day political world.
May I say that the majority of my colleagues in the medical profession do not share the view of the hon. Member for Carlisle. The men in medicine today are not the same men that were there in 1948; they have changed a lot. A decade has passed; some have died, some have retired and others have taken their place. There is a new generation and an entirely different attitude to the National Health Service. Those who were not happy with it at the beginning have seen it in practice and now welcome it.
It is a remarkable fact that today, when we are debating this matter, we know that every single doctors' organisation which has met to consider it has come out against these charges. Admittedly, the Fellowship for Freedom in Medicine, the welly-known Teddy boy group of high-powered consultants, have not yet met but we know what it will say. Like the hon. Member for Carlisle, the members of that group have been dead against the service since its inception.
My objection is that this particular method of paying for the Health Service, such as suggested, is bad from the point of view of medicine. I hope to argue the case that I believe many doctors, irrespective of their political views, sincerely hold against these charges. There is no point in going over who started it all, that seems to be irrelevant. We are talking of the validity of the charge.
I am extremely glad that the Labour Party never imposed the prescription charge, as such, because it was probably against that particular mechanism that the most serious charge of bad medical practice can be made. I can see the dilemma of my Liberal friends who are trying to find ways and means of making suggestions. I believe that the hon. Member for Bolton, West (Mr. Holt) took us to the slough of despair when he suggested that we might perhaps have a 10s. charge, or something in kind, and then went on to his other, and more interesting, idea that we should free all prescription charges on drugs at present on the British Pharmacopoeia. I second that, if I am in order in doing so. The trouble is that the Minister could not possibly accept that, because it would completely undo one of his principal sources of revenue to finance the


Service. The hon. Member for Devon-port at least made an attempt to find some way of getting round the awkward mechanism that the chronically sick are having to face in order to get this rebate—a rebate which my hon. Friend the Member for Lanarkshire, North (Miss Herbison) pointed out was impossible to achieve, on the word of the Minister in 1951. The hon. Lady suggested a National Assistance number. She meant very well, but I find it a very unpleasant suggestion.
If the Minister is unwilling to budge on these charges he might, perhaps, be willing to allow doctors to issue a certificate to all chronically sick persons which will exempt them from any charge whatsoever. That seems to be a reasonable idea. Give a card to everyone who, on the doctor's certification, is chronically sick. The card would be withdrawn when the doctor is of opinion that the patient is no longer in that condition. The production of the card at the chemist would mean that the charge could be waived. Each card could be numbered, and the stamping of the number on the prescription by the chemist would be sufficient, and no money need then be paid.
I do not know what the position will be among many of the patients of rural practitioners when they have to pay 2s. per item to the doctor who is also the dispenser. They may well become more annoyed than before when they have to pay the doctor 1s. I know that many doctors think that patients have a feeling that it is the doctor himself who is getting it.
One of the most galling things of all—perhaps this irritates doctors more than anything else—is that last night, on the Consolidated Fund Bill, Parliament voted a sum to meet the Pilkington recommendation for higher doctor's pay, and that sum is the very same as the amount to be raised by higher prescription charges. In other words, the doctors seem to be getting a rise because the patients will have to pay 2s. instead of 1s. per item. [An HON. MEMBER: "It is the other way round."] No. I think I am right. But whichever way it is, whether it arises from what happened last night or what we do tonight when we vote on the charges, the fact is that there is no con-

nection. The Minister has never pretended that there was a connection between the Pilkington award and the increase in prescription charges. That is not his excuse. His excuse is that we have a wonderful hospital building programme to embark on.
The noble Lord the Member for Hertford (Lord Balniel), the son of the Premier Earl of Scotland, who knows very little about the lives of the people, in my opinion, or he would not make the speeches he does, seems to have stopped doing research for the Conservative Research Department. He has his facts all wrong. He talked about the present hospital building programme as £50 million a year. It is not. That is what it is to be in 1964–65, if we are lucky, and under this Government we are extremely unlucky in these affairs. At present, in fact, it is to be £31 million. We are told that the complete ten year hospital building programme might be £500 million. It "might be" that. Those are the words of the Minister of Health. On average, that would be £50 million a year, which is £25 million a year less than the British Medical Association proposed, substantially less than what the Labour Party proposes, and substantially less than what is needed, in fact, if we are to get within seeing distance of solving our hospital difficulties at all soon.
The fact is that what is proposed is not really to finance the hospital building programme. The programme is going up by £6 million next year, from £25 million to £31 million, yet the Treasury will take in £65 million net gain from these new charges. In other words, the Treasury will in one year make ten times what the increase is to be in the hospital building programme.
Even supposing that the argument were that we shall iron it out in time, the fact is that, in eight years, by these increases of charge, the Treasury will have accumulated over £500 million, and this is the total sum of the whole hospital building programme itself. The Government will have been saved any additional expenditure.
The interesting feature to note is that the Minister gave his news conference on the same day that he attended the Cabinet meeting to discuss these charges. Of course, his news conference was all about the window-dressing. His visit


to the Cabinet meeting was to discuss the charges. The Secretary of State for Scotland, of course, is just as much involved as the Minister of Health. He does not have the same fanciful intelligence that the Minister of Health has in all the subtleties of argument we heard today. The Secretary of State is a simple man. When he spoke to the Tory women in Scotland on Saturday—those elderly matrons who are more interested in birching than in medical drugs—

Mr. Ellis Smith: In Scotland, too?

Dr. Mabon: I think it is the same all over. The female of the species is more dangerous, whether in England or in Scotland.
The Secretary of State told them outright, according to one Press report I have, that the Government's proposals are
entirely due to the fact that we must embark on this hospital programme.
The right hon. Gentleman knows how lamentable is the Scottish hospital programme. There is not a single Scottish Member who cannot stand up now and recite a list of the various extensions in his own constituency which have been pending for years. The fact is that none of us can say even now when these will take place.
It is not a plan that we have. There is no plan for the hospitals. There is no real £500 million plan at all. It does not exist. It is not in the Ministry of Health. The Department has not collected the facts yet. It has not sorted out the priorities. There is no plan. Yet we are being told tonight by the Secretary of State for Scotland and by the Minister of Health that they propose to raise these charges to bring in £65 million now in order to finance a programme which does not even exist. How long will the people take this sleight of hand? How long will they be misled?
Think of all the dreadful things which will happen consequent on these new prescription charges. We have seen the beginning of it. Anyone can see in any television programme on I.T.V. the amount of advertising—which, in my opinion, contravenes the Television Act—designed to encourage self-medication. It is quite deplorable. Yet we know that, if the two "bob" charge is insisted

on, the spread of self-medication will become greater. When we think of the number of cases which come to us of people who have medicated themselves for far too long and present themselves in a state of illness, particularly in the case of cancer, which is beyond cure, it is no wonder that we get passionate about these things.
The B.M.A., in its radical days in 1909 and 1910, when it was really an organisation to be proud of and not the one just liberated from the hypnotic spell of the Chancellor of the Duchy of Lancaster, went to town with the drug companies and told the people of the danger of self-medication and its wicked consequences. These days people are driven to seeking their own remedies. The message of medical science is, "If you have a complaint see a doctor. Do not run to your granny or take notice of a silly advertisement which pretends that it can cure your complaint." One of the great fears of medicine is that we might frighten people away from receiving advice at an early stage of illness.
I now wish to deal with the argument that we have heard this afternoon about prescriptions. When the 1s. per item rule came in in 1956, I went to the Renfrewshire National Health Service Executive Council concerning a complaint that had been lodged about a chemist who, in all innocence, had been told by a patient, "I cannot afford 3s. for these three items. Which item can I do without?" The chemist said, "If that is the case, do not take this one". He was immediately challenged by the executive council, and quite rightly so. In my opinion, no chemist has the right to change the prescription of a doctor at any time under any circumstances unless he is first willing to contact the doctor and make sure that all is well. It is a most dangerous procedure.
There is one thing in which the pharmacy profession does not wish too be involved. This was something that I was told this afternoon. I was told that chemists do not wish to be responsible for having to determine which particular item a patient should take in preference to another. What a deplorable idea it is that chemists should be in a position to make such a decision. Yet the Minister sat there triumphantly nodding his head indicating that he was willing that


chemists should make this decision. I hope that the doctors will challenge him on solid professional grounds. We have rules in medicine which have been observed for hundreds of years, and I disagree entirely with this innovation.

Mr. Powell: I neither nodded nor shook my head.

Dr. Mabon: The right hon. Gentleman's head almost fell off in his emphasising. My hon. Friend the Member for Southall (Mr. Pargiter) challenged him. If it is the case, as HANSARD will show, that the right hon. Gentleman indicated assent to the point made by my hon. Friend, perhaps he will take an early opportunity to correct the mistake which he made this afternoon. Doctors do not like to sit at tables deciding how many medicines should be prescribed for a patient. They wish to be free to prescribe fairly and honestly what, in their judgment, is right for a patient. Long ago they used to sit on one side of the table and say, "To which class does this patient belong—to the class which can afford any kind of medicine, or to the class which can afford only a certain type of medicine?"
Nowadays, we are back even beyond Lloyd George's time. In his time, at least a stamp meant that a working man could get his medicine free. Now, that no longer applies. The working man pays for his stamp and, in addition, for his medicine. The doctor, therefore, has to decide how these charges will influence him and will change his practice in medicine.
As will soon be learned from medical organisations, the relation between doctor and patient—which the Tories prophesied would be jeopardised but which, in the opinion of many people, including the doctors, has been improved—will be affected by these charges if it is affected at all. The Conservatives are, therefore, introducing their own irritants into these affairs.
I deplore, like almost every other doctor, the introduction of the new prescription charges and these new taxes on the Service. They are regressive and, for whatever political reason they are imposed, they certainly will not receive the support of the medical profession. I hope

that every doctor will lobby his Member of Parliament until such time as we can have these charges changed, even if we have to wait for a Labour Government.

9.2 p.m.

Mr. Peter Tapsell: In her eloquent speech, the hon. Lady the Member for Cannock (Miss Lee) said that the language of priorities was the religion of Socialism. While I certainly would not find that a very satisfying—[Interruption.] For the benefit of hon. Members opposite, I have been told to speak until ten minutes past nine. Therefore, they will not have to put up with me for more than about ten minutes.
The hon. Lady said that the language of priorities was the religion of Socialism. While I do not think that that would be an entirely satisfying religion, I certainly think that priorities in the social services are extremely important. That is precisely why I support the measures which my right hon. Friend the Minister of Health announced in the House last week and which he defended so ably this afternoon. Those measures are based, as has been generally agreed in the debate, not merely on administrative convenience but on sound political principles, and on political principles strongly felt. I share that feeling.
I realise that hon. Members opposite disagree passionately and sincerely with that principle. The right hon. Member for Belper (Mr. G. Brown), in opening the debate, was quite right in saying that there was a fundamental division between the two sides of the House on this issue. As I understand it, the party opposite believes that universal subsidies should be paid to everyone irrespective of need. It is around this point that many of the major political controversies of recent years have centred. One thinks of the arguments about food subsidies, the general housing subsidy and, indeed, the Rent Act. They all centred around this same argument.
Hon. Members opposite affect to believe, and some of them may still believe, that we on this side are hard-faced men who have done well out of the war and want to grind the faces of the poor. I assure hon. Members opposite that I care just as much for the social services as any hon. Member in this House. I would never support policies advocated by a Government which I thought were aimed


at damaging those social services. I believe, however, that our social services can be made more effective and more humane when Exchequer expenditure is made selective and is concentrated either on cases of individual need or on providing those services which, by their nature, the individual cannot provide for himself. Even the Beveridge Report never intended or implied that social services should be made indiscriminate with everybody, however poor, subsidising everybody else, however rich. In the affluent society that would be the economics of the madhouse.
The approach which many hon. Members opposite have to these problems is, I believe, inspired by pre-war memories instead of post-war experience. I think, judging by discussions which I have had with people who share their views, that two pre-war memories in particular which govern their thinking are the widespread unemployment between the wars and the way in which the household means test was operated between the wars. Those conditions, fortunately, are gone, and to the people of my generation—and I would say that the people of my generation, the younger, now form about one-third of the nation and will soon form one-half—the conditions prewar are almost as remote as Victorian England. What we are concerned with is today and tomorrow.
What, I am sure, the Government are rightly doing is to move away from combating a widespread pauperism which no longer exists and is now confined to special and easily identifiable groups and towards providing proper amenities and services for a fully employed and highly paid society. My right hon. Friend's proposals, with their shift of emphasis away from current expenditure in the Health Service towards capital expenditure and away from spending money on parts of the Health Service where the individual can reasonably be expected to make some provision himself towards parts where he cannot do so, are very much to be welcomed. I hope that this tendency will be carried further, not just in the National Health Service but in the welfare services as a whole.
It is not part of my argument that we as a country should spend less on the social services. On the contrary, I hope and believe that as the years go by and as our national income increases we

shall spend more and more on the social services, but I want to see that expenditure going where it is really needed, on building new hospitals, prisons—[Laughter.]—roads and all the other many things which we require. If the hon. Member over there laughs at the idea of building new prisons, I would ask him to come with me to some of the prisons which I visited in the past year and see the conditions people live in. If he does not think that that would be a valuable form of social expenditure I shall be very surprised.
I would say to hon. Members opposite that we in the Conservative Party profoundly believe in the social services. We want more money spent on them as the country can afford it, but we want to ensure that the money is spent where that money will do the most good and not on providing broadcast benefits for people many of whom do not need them and would rather make provision themselves for their own needs.

9.8 p.m.

Mr. Kenneth Robinson (St. Pancras, North): I should first like to thank the Minister for the very kind words which he used in relation to the new responsibilities which have just fallen on my shoulders. We shall, no doubt, be facing each other with some frequency in the next few weeks, but if the duel is a prolonged one, at least I look forward to it.
I should also like to add my congratulations from this side of the House to the hon. Member for Ludlow (Mr. More) on a most admirable maiden speech. He and I share the experience of hospital administration in a voluntary capacity, he on a management committee, I on a regional board, and I only hope that he will find that experience as valuable in this House as I have done.
I have found this an extremely interesting debate. I must say that I thought it was a little surprising that we did not hear from either of the right hon. Gentleman's two predecessors who are on the back benches. The right hon. and learned Gentleman the Member for Hertfordshire, East (Sir D. Walker-Smith) was here part of the time but he did not see fit to intervene. There has been singularly little attempt throughout this debate on the part of hon. Members opposite to counter the arguments of my hon. Friends.
Indeed, I think that our case has been made so cogently, first of all by my right hon. Friend the Deputy Leader of the Opposition, and later by others of my hon. Friends, that there really is very little left for me to do—very little beyond, perhaps, summarising the case and answering one or two points made by the Minister. Before doing so, I should like to deal with one matter raised by the noble Lord the Member for Hertford (Lord Balniel).
He is a good debater and usually a fair one, but he was falling a little below his form when he talked with mock indignation about the Budget of my right hon. Friend the Leader of the Opposition and about the ceiling on the Health Service without bothering to remind the House that this was essentially a temporary ceiling, that any charges that were imposed then lapsed automatically after three years, that we were in the Korean War, that we were facing vastly expanded defence costs—and that it was at a time six years and not 16 years after the Second World War.
The Minister made a very curious speech in reply to my right hon. Friend the Member for Belper (Mr. G. Brown). The first two-thirds seemed much more like a speech introducing Health Estimates than a reply to a Motion of censure. In the course of these passages, he gave us, I agree, some very interesting information, and on this I will be very glad to comment on some future occasion.
I want to say only this one thing about that part of the speech tonight, and that is to congratulate him on securing Sir John Wolfenden as chairman of the National Councils for the Training of Health Visitors and Social Workers. It is an excellent choice, although in the light of the Government's treatment of him as chairman of another body to which they appointed him I am a little surprised at his accepting this invitation.
The Minister's case for these increases in charges and contributions has one virtue: it is a simple and straightforward case. He told us last week, and again today, that the Health Estimates are continuing to rise and would have been up by 11 per cent. next year, that the Service is costing the Exchequer more than we can afford and, therefore, economies have to be found. He claims

that he is faced with two alternatives. The first is that of curtailing the Service, of cutting back development—perhaps development already planned—and the second is finding more money from patients and contributors. He says that faced with these alternatives he chose the latter.
In our opinion, this dilemma which he has described is a wholly false one. As some of my hon. Friends have done, I want to challenge his basic assumptions. It is a curious thing that whenever Conservative Governments get into economic difficulties their first instinct—one might almost call it a Pavlovian reflex—is to cut the social services. In this kind of surgery—perhaps mutilation is a better word—the National Health Service is always the first one to suffer. The cry put by the Government and from the benches opposite is that the Service is costing more than the nation can afford—as if health is a thing one can afford or not at choice.
We have heard this cry before. We heard it from the present Secretary of State for the Colonies when he became Minister of Health in 1952. I think it was in the following year that he set up a Committee the main purpose of which was to investigate the Service, which had then only been going for five years, and to recommend how a rising charge to the Exchequer could be avoided. When that Committee reported, in 1956—it was, of course, the Guillebaud Committee—it told the Minister that, far from rising, the cost of the Health Service had been steadily falling in relative terms, that is, expressed as a percentage of the national income. That decline continued for one or two more years, and then steadied and flattened out and very slowly began to creep up again. The increases in recent years in the financial cost of the Service—I am not now talking about its relative cost—have been mainly due to increased wages and salaries.
We can all agree that five years ago, a little more or a little less, salaries in the Service were disgracefully low, and I am very glad that some of them have undergone improvement and that some of the anomalies vis-à -vis other comparable occupations have been recognised. Certainly wages and salaries have been responsible for most of the increases, but, even so, there is no indication of


any significant rise in costs in recent years.
The Minister gave a Written Answer today bringing up to date the Guillebaud tables, the operative tables showing the percentage of the national income devoted to the Service. They confirm that even today in this so-called affluent Tory society we are not spending so much of the national income on the Health Service as we were in 1950.
What is this panic bleat about the increasing burden? By the only honest yardstick, that is, as a proportion of the national income, we are getting our Health Service more cheaply than we were ten years ago. On almost any statistical basis—and these are very complex calculations, as the Minister knows—on gross costs, net costs, Exchequer expenditure, public authority expenditure, one arrives at much the same result every time, and not one of those calculations supports the Minister's plea that the costs of the Service are getting out of hand.
My right hon. Friend the Member for Belper quoted the Treasury Bulletin for Industry, but there was one figure which he did not mention. In the last ten years, the actual net expenditure on the Health Service, that is, in money terms, has risen by about 80 per cent. but that on education in the same period has risen by 160 per cent. or rather more. That suggests that the Health Service has not been getting out of hand. The Exchequer itself has been getting off still more lightly.
The Minister suggested that the Exchequer contribution which will result from these changes will be no lower than it was under the Labour Government or at the beginning of the Service, but the Treasury has announced, I understand in an official statement, that the new changes will mean a fall in the Exchequer contribution to 71 per cent. next year which is the lowest proportion since the Service began—71 per cent. next year while in 1956 it was 83 per cent.
Those are arid, statistical calculations. Does the right hon. Gentleman never stop to consider the dividends of the Health Service? I do not mean even in terms of human happiness, but in straight economic terms, in keeping people at work and getting them back to work after

they have been sick. The whole trend of successive Conservative Administrations has been to shift the financial burden of this Service progressively from the Exchequer to the patient himself, at the time of greatest need, and to the public at large on a poll tax basis.
The result of this is that the patients, who paid in all a mere £2 million or £3 million for pay-beds in 1950, will now be forking out more than £50 million in direct charges. As regards the contributor, he was paying 8½ d. per week in 1950. He is soon to pay 2s. 8½ d., an increase of nearly 300 per cent.
We can deal in more detail with contributions under the Ways and Means Resolution and the subsequent stages of the Bill. I want to say a word about the effect of these increased charges on the patient himself. First, I want to consider the prescription charge. Here, quite naturally, the heaviest burden will fall on the chronic sick. I happened to see yesterday the analysis of a random list from a London teaching hospital of regular out-patients needing prescriptions. These were regular weekly attenders. They had broken up this list into those who wanted prescriptions with one, two, three or four items. Several of these, I think it was at least five out about 50 or 60, had five item prescriptions—10s. under the right hon. Gentleman's proposals. There were many more with three or four items.
The Minister says that he will encourage doctors to prescribe for long periods, but that is not possible in many of these cases. Does he not remember when we last had the prescription charge increased, when I think it went from per form to per item, the then Minister of Health gave all sorts of promises about the packs he would arrange and about the block prescriptions, but in the end it boiled down to practically nothing? There were either technical difficulties, administrative difficulties or medical difficulties, but very little was done.
The right hon. Gentleman said today that he would arrange a pack for diabetics.

Mr. Powell: Mr. Powellindicated dissent.

Mr. Robinson: There is some kind of pack for diabetics at the moment. It


has been mentioned many times. It does not cover insulin, which is what the diabetic needs most urgently. It does not cover it because of the difficulties of storage and keeping it fresh.
The fact is that one cannot effectively minimise the burden of these charges on the chronic sick. These charges have once again been roundly condemned by the medical profession, as my hon. Friend the Member for Greenock (Dr. Dickson Mabon) reminded the House. They have always been condemned by the doctors. They were described as a tax on illness. They were condemned by the Hinchliffe Committee. Indeed, I think it is only the Government who are in favour of the prescription charge, and there is no doubt that this 2s. per item will deter quite a large number of people from visiting their doctors.
The Minister brushes this aside and says that, after all, it is a charge of comparatively minor dimensions. I should like to take one hypothetical case. It is quite a common sort of case. A small child has an earache, a complaint which is often trivial and transitory. The mother is poor, not particularly intelligent, and has not heard about arrangements for hardship refund and how to get that to which she is entitled. She remembers that the last time the child had an earache she took him to the doctor and got a prescription for perhaps ear drops, an antibiotic, and a tonic—three items which will now cost 6s. The family is particularly hard up that week and so she takes a chance. The child is not taken to the surgery although, in fact, it probably has bad middle ear infection or even an incipient mastoid or something that could lead to deafness. The child goes without treatment simply because the woman has been deterrd by that charge. One may say that she is irresponsible, but the fact is that the prescription charge encourages just such irresponsibility. If we double the charge we double the encouragement. It is little better than imposing a charge for visiting the doctor—and I have no doubt that that is what many hon. Members opposite would like to see.
Unless we distribute the costs fairly the benefits of the Service will not be fairly distributed. If we compromise

on one principle we shall compromise on another. It is not good enough for the Minister to fall back on the National Assistance Board arrangements, saying that in cases of hardship refunds can be obtained. I will not read again the figures that I gave him in an intervention, showing the miserably small number of special hardship cases which are refunded by the Board, but if we take the whole of its refunds we find that eleven out of twelve people have to pay their prescriptions in full. Only one person in twelve gets a refund—including those with regular weekly National Assistance payments. The system of refunds at best is a very cumbersome one. The offices of the Board may be nowhere near the chemist's, and it may involve a bus journey both ways in order to claim a refund. At best that is inconvenient because it may involve fares, and for some people it is ignominious because it involves a means test.
We can deal in greater detail with the other charges, on teeth and spectacles, in tomorrow's debate. I want to turn to the effect of those charges upon the right hon. Gentleman's estimates. He has told us that he expects to double the revenue from the doubled prescription charge, which sounds logical enough in all conscience. There will be some saving in the drug bill through people not seeking the treatment which they need, but it will be a saving at the cost of their health. But any savings which there may be under this head will be more than offset by increased over-prescribing, especially by the kindlier and more considerate doctors. They will tend to prescribe quantities for two weeks ahead instead of one. It is no good the Minister circularising general practitioners about the wickedness of over-prescribing if, at the same time, he sets up a conflict between the doctor's humane instinct and duty to protect the patient, on the one hand, and his somewhat remoter duty to the Chancellor on the other.
So the drug bill will continue to rise, and who will be happier to see half-full bottles of medicine going down the sink than the drug manufacturers? I predict that the 2s. charge will produce a far more lucurative revenue for the drug manufacturers than for the right hon. Gentleman's estimates. If he really felt compelled to make economies, why,


instead of milking the patient and the contributor, did he not turn his attention with equal ruthlessness to drug prices, especially those of the American manufacturers which he knows, which the Public Accounts Committee knows, which the Press knows and which everybody knows to be grossly inflated? He has announced that he is taking some steps, and we shall wait to see how determined those steps are.
I now turn to a matter with which we can deal when we debate the prescription charges Order, but I should like to ask the Financial Secretary—since the Minister did not answer my right hon. Friend—about free drugs for private patients. Can we now have a categorical assurance that this proposal is out, indefinitely? It would be absolutely monstrous and intolerable if, in doubling the prescription charge to the ordinary poor people, any change were made in providing free drugs to private patients who can afford to buy them.
There is one item in respect of which the estimated saving of the right hon. Gentleman will be precisely achieved, namely, on the welfare foods. What he is going to do is to eliminate the entire subsidy—the indiscriminate subsidy, as he called it—which places these supplements within the reach of every mother. It means that orange juice will now cost about four times as much as before, that cod liver oil and tablets will cost 1s. a bottle and 6d. a packet. This time it is the children who will suffer. Clearly this supplement must have been a positive contribution to the health of children. Equally clearly, far fewer mothers and children who now have them will get them in future—and this to save the right hon. Gentleman a paltry £1,500,000. I say "paltry" but I must not forget the two concessions, which he announced in his statement, to nursing and expectant mothers and children of free dentures and spectacle allowances for children over ten at a total cost of £270,000, which was hardly worth mentioning in a statement which increases charges by £65 million.
The point has been made time and again about the disparity between the figures involved in the much trumpeted capital expenditure on the hospital service of £5 million a year as against £65 million a year which the Minister is

clawing back from the patient public. I will not labour the point any further. But, of course, as more than one of my hon. Friends has said, the biggest increase in cost in the last year in the Health Service was the Pilkington award to doctors. How are the Government to meet this bill? By putting the burden on to the patient at his time of need. I do not think that doctors will be particularly happy to think that their increases in salary are coming from the pockets of the sick in the form of prescription charges.
We have said that these new impositions represent not only the most serious attack yet made on the National Health Service but a new and significant inroad into the whole principle of the Welfare State. It is part of the familiar Tory pattern, to the design of which the right hon. Gentleman has made a considerable contribution in the course of his political life. To me and to my right hon. and hon. Friends the whole justification of the Welfare State lies in its contributions to human happiness, something rather more than the mere elimination of avoidable misery. This idea was quite well put in an extract from a speech which I read some weeks ago and which stated:
In any given state of society and medical knowledge there is an ideal application of the available resources which will yield the greatest harvest in terms of health, well-being, comfort, reassurance—in short, of happiness. We shall never quite attain this ideal, but we ought to be tending towards it.
That brings me to the Minister himself, for it was he who uttered those brave words—so out of character—in his first major speech as Minister of Health at Llandudno last October. The words ring a little hollow today. But at the time they impressed the leader-writer of The Times newspaper sufficiently to write that
fears that the Minister would be over-zealous about finding economies do him less than justice.
Presumably that impression was shortlived because the same newspaper began its editorial last Thursday with this sentence:
That Mr. Powell should take his Ministerial axe to the Health Estimates is no surprise.
Those who were shocked and surprised should have known better. When the right hon. Gentleman, with his notorious


passion for cutting Government expenditure, was appointed to a great spending Department a mere two and a half years after those "little local difficulties," it was his axemanship that was needed. Whether he was the initiator of these cuts or merely the willing agent, he has dealt his Service a grievous blow and it is unlikely to be the last. As The Times said last Thursday:
It is worth wondering, for example, how long it will be before further increases in charges will be made on the basis of budgeting inconvenience.
The Minister, in his ten years in this House, has gathered an unusual fund of respect from both sides for his courage, his integrity and his intellectual capacity. They are all qualities which were very manifest in the speech he made in the debate on the Hola massacre last April, a speech which many who heard it—certainly I—will long remember. But there is another side to his political character. He seems to display a curiously bleak and blinkered attitude to people, as if he regards people as statistical entities and consumers of Exchequer funds. Austerity fits him like a hair shirt. His Ministerial record has been referred to in the debate, and I shall not weary the House with it any more, but it must be very convenient to a Government to have at its disposal a Minister who seeks mass unpopularity with the single-mindedness of the right hon. Gentleman.
His proposals have been almost universally condemned, which doubtless serves to convince him all the more of the rectitude of his policy. He reminds me of that other enigmatic gentleman, the Akhond of Swat, of whom Edward Lear wrote:
Does he study the needs of his own dominion
Or doesn't he care for public opinion
A jot
The Akhond of Swat?
Not caring a jot for public opinion is perhaps the only self-indulgence the Minister permits himself. No doubt when he comes to write his autobiography he will proudly entitle it, "No Love for Enoch."
These qualities have their place—of course they have—in government as elsewhere, but one is bound to ask if this

particular combination of qualities is quite what is needed to administer a great human service like the National Health Service. The Observer newspaper told us last Sunday that the right hon. Gentleman knows twelve languages. There is one of which he knows nothing. It was mentioned, oddly enough, by the hon. Member for Nottingham, West (Mr. Tapsell), but it was first mentioned in one of the most memorable and moving speeches I ever heard Aneurin Bevan make—" The language of priorities". That used to be the very essence of the National Health Service as Nye Bevan and the Labour Government created it.
I wish to correct the Minister. This, incidentally, was not a Service which both sides of the House did their best to create. It was a Service which hon. Members opposite did their best to abort. These proposals are going to cause suffering and hardship—how much no one can say—suffering inflicted on people in their time of greatest need when they are ill and specially vulnerable. The more ill they are the more they will pay. The same is true of the contributions, the poorer people are the more they will pay in proportion to income.
Labour remains firmly pledged to the principle of a Health Service free to the patient. The right hon. Gentleman has taken a step which widens immeasurably the breaches already made in the basic principle that health and care in time of sickness is a right of our people. He said last week that he would have been betraying his trust had he agreed to an increase in the budgetary cost of the Service. It is because in our view he has betrayed his trust that we have tabled this Motion of censure and I ask the House to support it.

9.39 p.m.

The Financial Secretary to the Treasury (Sir Edward Boyle): The hon. Member for St. Pancras, North (Mr. K. Robinson) has delivered an interesting speech on the subject of my right hon. Friend the Minister of Health. I should have preferred to hear him or some other hon. Member answer some of the arguments which my right hon. Friend used this afternoon. I have listened to nearly all the debate and none of my right hon. Friend's points have been met.
Before I turn to more controversial matters, I shall carry the whole House with me if I join in the congratulations to my hon. Friend the Member for Ludlow (Mr. More) on his very thoughtful and interesting speech based, as he showed us clearly, on personal experience of the hospital service.
This has been a serious and interesting debate, and there is one simple reason for that: in Britain the ordinary man in industry knows well that he need no longer feel anxious for himself or for his family if he is ill and cannot work, as so many people felt anxious years ago. We are just as glad about this as are right hon. and hon. Members opposite. Secondly, this state of affairs will in no way be altered by the charges which we are discussing on the Motion of censure. We can argue at Budget time—no doubt we shall argue a good deal when we reach it—about the distribution of the national income, but nothing can alter the fact that the 1950s in Britain were the best decade ever for the ordinary industrial workers. They were marked by a rapid increase in the standard of living, unexampled in our national history and a rapid increase in our social standards, too. It is nonsense for the Labour Party to talk as though they alone were identified with the ordinary workers in this country. That claim flies in the face of three General Elections and a great deal of evidence published since the last election.
One curious feature of the earlier debate was the very surly reception of the good news which my right hon. Friend the Minister of Health gave the House, equalled only by the extraordinary reception of the remark by my hon. Friend the Member for Nottingham, West (Mr. Tapsell) about the importance of the prison service. My right hon. Friend the Minister of Health gave the House extremely good news about the increase in the number of hospital doctors and nurses, the sharp increase in treatments and the very important news about the hospital building programme.
Right hon. and hon. Gentleman opposite asked for the details of the schemes which have been approved. Let me give them. Over 190 major schemes have already been announced for 1955–60, of which 31 have been com-

pleted, 27 are in progress on the site and 140 are in various stages of planning. These include 36 new hospitals, of which 10 are partly built, 7 are building and 19 are in the course of planning. The programme also includes 7 new dental hospitals in the course of planning and building. Furthermore, on 25th January, a new list of major hospital schemes was announced, and this contains no fewer than 29 schemes, of which 6 are new hospitals and 23 are projects of development and modernisation.
The point which I wish to emphasise is that there is to be a continuous rise in the hospital building programme from: £24 million-£25 million this year to a total of £50 million by 1965–66. Hon. Members opposite say that we should have made more rapid progress earlier in the hospital building programme, but, in that case, since they believe that the language of priorities is the religion of Socialism, I must ask them what part of the public investment programme they would have put further back in the queue. Would they rather have had fewer schools or fewer roads?
I am talking here about the public sector. There has never been any dispute in the House that we must have some scheme of priorities in the public sector. I ask hon. Gentlemen opposite to what they would have accorded a lower priority if hospital building was to have had a higher priority.
I come on now to a point I was asked by the hon. Member for Southall (Mr. Pargiter), who suggested that under the general grant system there was no guarantee that local health services would receive the Exchequer proportion of relevant expenditure. I assure the hon. Gentleman that the history of the two general grant settlements with the local authority associations shows that there is no truth in that accusation. In both cases local health services have attracted the full Exchequer grant at the rate of over 50 per cent. of approved relevant expenditure, and on the last occasion the increase in the cost to local health services was considerable and attracted Exchequer grant at the same rate as other general grant services.
There is every reason to suppose that when future general grants are settled this pattern will be followed, except that by then the proportion of local health to


total relevant expenditure for general grant will very likely have risen. [An HON. MEMBER: "What is the hon. Gentleman talking about?"] If the hon. Gentleman had listened he would have realised that I was answering a question asked by the hon. Member for Southall during the debate.
I propose to say now, if the House will permit, a few words on the subject of public expenditure, because one must view these charges and the proposed increase in contributions against the background of rising public expenditure as a whole. It is fully recognised on both sides of the House that, on the one hand, we must provide the public services which the community needs but, on the other hand, that if the Government pre-empt for their own public services too high a proportion of the resources we produce we shall find it difficult to find resources for other forms of economic activity which, by general understanding, are just as important and valuable to the community.

Mr. A. Woodburn: Mr. A. Woodburn (Clackmannan and East Stirlingshire) rose —

Sir E. Boyle: No, I will not give way. I have been interrupted a good deal in the course of my speech. I intend to say a few words on this subject now without further interruption. In 1952 public expenditure when we first took office was running at the proportion of 45½ per cent. of the gross national product. It then fell steadily to about 40 per cent. in 1957. Since 1957 the proportion of public expenditure to gross national product has been rising again. In virtually every part of the public sector today there is a strong expansion in expenditure. In the course of a decade, (he cost of education has increased from about 3 per cent. of the gross national product to over 4 per cent.
The hon. Gentleman asked about health expenditure. Those figures have already been given in this debate. Expenditure on health has increased from about 3· 4 per cent. of the gross national product in 1957 to just about 4 per cent. at the present time—[HON. MEMBERS: "What about 1950?"] In 1950 it was also 4 per cent., but education—[Interruption.]—in 1950 was a good deal lower. Obviously, if other services expand, it is extremely difficult for any

particular service to maintain its proportion, and I think that the Government have nothing whatever to be ashamed of in the proportions that social expenditure has taken of the national product during the last ten years.
At the same time, no responsible Government can possibly ignore rising trends in public expenditure. As the House is very well aware, the original Estimates presented last year showed an increase of some £342 million. I can tell hon. Members that next week, when the Vote on Account is published, they will find that the Estimates for the forthcoming financial year would again have shown an increase of well over £300 million but for the steps we are now discussing.
I maintain that in those circumstancs, the action of the Government is perfectly reasonable and only responsible. After all, we are here dealing with a problem that has faced all Governments in their turn. In this debate, hon. Members have frequently shown that they do not want to be reminded of what they did in 1950 and 1951, but let us not forget that in his 1950 Budget—[HON. MEMBERS: "Korea."]—this was before the Korean War; this was in April, 1950, nearly three months before the Korean War—Sir Stafford Cripps said of the Health Service:
Any expansion in one part of the Service must in future be met by economies or. if necessary, by contraction in others."—[OFFICIAL REPORT, 18th April, 1950; Vol. 474. c. 59.]
I believe that, as my right hon. Friend said, that statement was much more damaging to the National Health Service than are the Government's present proposals.
There is another point about Government expenditure which we should remember. In the early years of the 'fifties the reduction in the defence programme was there to make room for expanding social service programmes, but if one now looks ahead and indulges in what hon. Members opposite approve of, namely, a little forward planning in the sphere of Government expenditure, one discovers no big contracting programmes. The problem of any Government must be to contain this growth of expenditure and keep it within reasonable bounds. Faced with the figures before us today, I feel that the Government have taken only a reasonable and


responsible course, in view of the Estimates coming before the House, in making these increases in charges and contributions.
A further point that one should not forget is that not only in relation to hospital building but right across all Government capital expenditure we are seeing an increase. The hon. Member for St. Pancras, North (Mr. K. Robinson) said that a capital expenditure of £50 million over a period of some years seemed to him small compared with the total cost of the Service, but we should not forget the programme of increased capital expenditure in the social services as a whole. Both the education service and the Health Service depend for their progress on increased capital expenditure, and increased efficiency as well—

Mr. K. Robinson: What I said was that an increase in the capital programme at the rate of £5 million a year was chicken feed compared with the £65 million a year saved by these proposals.

Sir E. Boyle: I return to the point—[HON. MEMBERS: "Answer."] I will answer the hon. Gentleman's point. The increase of £5 million a year in capital expenditure will be of infinitely greater benefit to the National Health Service than the charges we are now considering can possibly prove of damage to it, so I have no doubt whatever that we are right, in our social service policy, in giving priority to capital expenditure but not failing, when necessary, to take unpopular decisions in regard to current expenditure. Whatever may have been said in this debate, and whatever may be said in the House, I believe that there is a wide measure of agreement in the country—[An HON. MEMBER: "What country?"]—this country—on the desirability of assuring good standards for those who are poorest in the community. I believe there is no dispute that those in need should have the best possible hospital treatment. This has been one of a pattern of debates that we have at regular intervals in the House and with which we are extremely familiar. The truth is that it is not an attack on Government policy but on Government

policy as the Opposition would like it to be. When one considers the whole economic and social history of Britain in the 1950s and considers the rise in living standards and in social standards and the better distribution of incomes in the country—[HON. MEMBERS: "Oh."]—if hon. Members disagree with that let them look at the article written by their own hon. Friend the Member for Grimsby (Mr. Crosland) in this month's Encounter. He makes that point as compared with 1949. I believe it to be perfectly true.

There is no truth in any of the strictures which have been made against this side of the House during this debate, and I believe that, despite all the sound and fury we have had at intervals in these proceedings, they will not be echoed in the country as a whole.

We have every confidence in our record of achievement, just as, at the same time, we will not hesitate to take unpopular decisions in order to safeguard those achievements we have already made. It is with every confidence that I ask the House to reject this Motion.

Mr. Woodburn: Mr. Woodburnrose —

Hon. Members: Oh.

Mr. Speaker: Order. I hope the House will give the right hon. Gentleman a hearing.

Mr. Woodburn: I wanted to ask the hon. Gentleman a courteous question. The hon. Member continually referred to public expenditure. I think that he means Government expenditure. If the public spend more as a result of the prescription charges and the Government save on expenditure, how is that a saving in the national economy, public expenditure or Government expenditure? The public are likely to spend more.

Mr. Herbert W. Bowden: Mr. Herbert W. Bowden (Leicester, South-West) rose in his place, and claimed to move, That the Question be now put.

Question, That the Question be now put, put and agreed to.

Question put accordingly: —

The House divided: Ayes 231, Noes 321.

Division No. 40.]
AYES
[10.0 p.m.


Abse, Leo
Allaun, Frank (Salford, E.)
Bacon, Miss Alice


Ainsley, William
Allen, scholefield (Crewe)
Baird, John


Albu, Austen
Awbery, Stan
Baxter, William (Stirlingshire, W.)




Beaney, Alan
Hill, J. (Midlothian)
Plummer, Sir Leslie


Bellenger, Rt. Hon. F. J.
Hilton, A. V.
Prentice, R. E.


Bence, Cyril (Dunbartonshire, E.)
Holman, Percy
Price, J. T. (Westhoughton)


Blackburn, F.
Holt, Arthur
Probert, Arthur


Blyton, William
Houghton, Douglas
Proctor, W. T.


Boardman, H.
Howell, Charles A.
Pursey, Cmdr. Harry


Bowen, Roderic (Cardigan)
Hoy, James H.
Rankin, John


Bowles, Frank
Hughes, Cledwyn (Anglesey)
Redhead, E. C.


Braddock, Mrs. E. M.
Hughes, Emrys (S. Ayrshire)
Reid, William


Brockway, A. Fenner
Hughes, Hector (Aberdeen, N.)
Reynolds, G. W.


Broughton, Dr. A. D. D.
Hunter, A. E.
Roberts, Albert (Normanton)


Brown, Alan (Tottenham)
Hynd, H. (Accrington)
Roberts, Goronwy (Caernarvon)


Brown, Rt. Hon. George (Belper)
Hynd, John (Attercliffe)
Robinson, Kenneth (St. Pancras, N.)


Butler, Herbert (Hackney, C.)
Irvine, A. J. (Edge Hill)
Ross, William


Butler, Mrs. Joyce (Wood Green)
Irving, Sydney (Dartford)
Royle, Charles (Salford, West)


Callaghan, James
Janner, Sir Barnett
Shinwell, Rt. Hon. E.


Castle, Mrs. Barbara
Jay, Rt. Hon. Douglas
Short, Edward


Chetwynd, George
Jeger, George
Silverman, Julius (Aston)


Cliffe, Michael
Jenkins, Roy (Stechford)
Silverman, Sydney (Nelson)


Collick, Percy
Johnson, Carol (Lewisham, S.)
Skeffington, Arthur


Corbet, Mrs. Freda
Jones, Rt. Hn. A. Creech (Wakefield)
Slater, Mrs. Harriet (Stoke, N.)


Craddock, George (Bradford, S.)
Jones, Dan (Burnley)
Slater, Joseph (Sedgefield)


Cronin, John
Jones, Jack (Rotherham)
Small, William


Crosland, Anthony
Jones, J. Idwal (Wrexham)
Smith, Ellis (Stoke, S.)


Crossman, R. H. S.
Jones, T. W. (Merioneth)
Snow, Julian


Cullen, Mrs. Alice
Kelley, Richard
Sorensen, R. W.


Darling, George
Kenyon, Clifford
Soskice, Rt. Hon. Sir Frank


Davies, G. Elfed (Rhondda, E.)
Key, Rt. Hon. C. W.
Spriggs, Leslie


Davies, Harold (Leek)
King, Dr. Horace
Steele, Thomas


Davies, Ifor (Gower)
Lawson, George
Stewart, Michael (Fulham)


Davies, S. O. (Merthyr)
Ledger, Ron
Stonehouse, John


Deer, George
Lee, Frederick (Newton)
Stones, William


de Freitas, Geoffrey
Lee, Miss Jennie (Cannock)
Strachey, Rt. Hon. John


Delargy, Hugh
Lever, Harold (Cheetham)
Strauss, Rt. Hn. G. R. (Vauxhall)


Dempsey, James
Lever, L. M. (Ardwick)
Stross, Dr.Barnett (Stoke-on-Trent,C.)


Diamond, John
Lewis, Arthur (West Ham, N.)
Swain, Thomas


Dodds, Norman
Lipton, Marcus
Swingler, Stephen


Donnelly, Desmond
Loughlin, Charles
Sylvester, George


Driberg, Tom
Mabon, Dr. J. Dickson
Symonds, J. B.


Ede, Rt. Hon. C.
McCann, John
Taylor, Bernard (Mansfield)


Edelman, Maurice
MacColl, James
Thomas, George (Cardiff, W.)


Edwards, Rt. Hon. Ness (Caerphilly)
McInnes, James
Thomas, Leslie (Canterbury)


Edwards, Robert (Bilston)
McKay, John (Wallsend)
Thompson, Dr. Alan (Dunfermline)


Edwards, Walter (Stepney)
Mackie, John
Thomson, G. M. (Dundee, E.)


Evans, Albert
McLeavy, Frank
Thornton, Ernest


Fernyhough, E.
MacMillan, Malcolm (Western Isles)
Thorpe, Jeremy


Finch, Harold
Mallalieu, E. L. (Brigg)
Timmons, John


Fitch, Alan
Mallalieu, J.P.W. (Huddersfield,E.)
Tomney, Frank


Fletcher, Eric
Manuel, A. C.
Ungoed-Thomas, Sir Lynn


Foot, Dingle (Ipswich)
Mapp, Charles
Wade, Donald


Foot, Michael (Ebbw Vale)
Marquand, Rt. Hon. H. A.
Wainwright, Edwin


Forman, J. C.
Marsh, Richard
Warbey, William


Fraser, Thomas (Hamilton)
Mason, Roy
Watkins, Tudor


Galtskell, Rt. Hon. Hugh
Mayhew, Christopher
Wells, Percy (Faversham)


Galpern, Sir Myer
Mellish, R. J.
Wells, William (Walsall, N.)


George, LadyMeganLloyd (C'rm'rth'n)
Mendelson, J. J.
White, Mrs. Eirene


Ginsburg, David
Millan, Bruce
Whitlock, William


Gooch, E. G.
Milne, Edward J.
Wigg, George


Gordon Walker, Rt. Hon. P. C.
Mitchison, G. R.
Wilcock, Group Capt. C. A. B.


Gourlay, Harry
Monslow, Walter
Wilkins, W. A.


Greenwood, Anthony
Morris, John
Willey, Frederick


Grey, Charles
Mulley, Frederick
Williams, D. J. (Neath)


Griffiths, Rt. Hon. James (Llanelly)
Neal, Harold
Williams, Ll. (Abertillery)


Griffiths, W. (Exchange)
Noel-Baker,Rt.Hn.Philip (Derby, S.)
Williams, W. R. (Openshaw)


Gunter, Ray
Oram, A. E.
Willis, E. G. (Edinburgh, E.)


Hale, Leslie (Oldham, W.)
Oswald, Thomas
Wilson, Rt. Hon. Harold (Huyton)


Hall, Rt. Hon. Glenvil (Colne Valley)
Owen, Will
Winterbottom, R. E.


Hamilton, William (West Fife)
Padley, W. E.
Woodburn, Rt. Hon. A.


Hannan, William
Pannell, Charles (Leeds, W.)
Woof, Robert


Hart, Mrs. Judith
Pargiter, G. A.
Wyatt, Woodrow


Hayman, F. H.
Parker, John (Dagenham)
Yates, Victor (Ladywood)


Healey, Denis
Parkin, B. T. (Paddington, N.)
Zilliacus, K.


Henderson, Rt.Hn.Arthur (Rwly Regis)
Pavitt, Laurence
TELLERS FOR THE AYES:


Herbison, Miss Margaret
Pearson, Arthur (Pontypridd)
Mr. Bowden and Mr. Rogers.


Hewitson, Capt. M.
Peart, Frederick




Pentland, Norman





NOES


Agnew, Sir Peter
Barlow, Sir John
Berkeley, Humphry


Allan, Robert (Paddington, S.)
Barter, John
Bevins, Rt. Hon. Reginald (Toxteth)


Amery, Rt. Hon. Julian (Preston, N.)
Batsford, Brian
Bidgood, John C.


Arbuthnot, John
Baxter, Sir Beverley (Southgate)
Biggs-Davison, John


Ashton, Sir Hubert
Beamish, Col. Sir Tufton
Bingham, R. M.


Atkins, Humphrey
Bell, Ronald
Birch, Rt. Hon. Nigel


Balniel, Lord
Bennett, F. M. (Torquay)
Bishop, F. P.


Barber. Anthony
Bennett, Dr. Reginald (Cos &amp; Fhm)
Black, Sir Cyril







Bossom, Clive
Grosvenor, Lt.-Col. R. G.
Maitland, Sir John


Bourne-Arton, A.
Gurden, Harold
Manningham-Buller, Rt. Hn. Sir R.


Box, Donald
Hall, John (Wycombe)
Markham, Major Sir Frank


Boyd-Carpenter, Rt. Hon. John
Hamilton, Michael (Wellingborough)
Marlowe, Anthony


Boyle, Sir Edward
Hare, Rt. Hon. John
Marples, Rt. Hon. Ernest


Braine, Bernard
Harris, Frederic (Croydon, N.W.)
Marshall, Douglas


Brewis, John
Harris, Reader (Heston)
Marten, Neil


Bromley-Davenport,Lt.-Col.SirWalter
Harrison, Brian (Maldon)
Mathew, Robert (Honiton)


Brooke, Rt. Hon, Henry
Harvey, Sir Arthur Vere (Macclesf'd)
Matthews, Gordon (Meriden)


Brooman-White, R.
Harvey, John (Walthamstow, E.)
Maudling, Rt. Hon. Reginald


Browne, Percy (Torrington)
Harvie Anderson, Miss
Mawby, Ray


Bryan, Paul
Hastings, Stephen
Maxwell-Hyslop, R. J.


Bullard, Denys
Hay, John
Maydon, Lt.-Cmdr. S. L. C.


Bullus, Wing Commander Eric
Heald, Rt. Hon. Sir Lionel
Mills, Stratton


Burden, F. A.
Heath, Rt. Hon. Edward
Montgomery, Fergus


Butcher, Sir Herbert
Henderson, John (Cathcart)
More, Jasper (Ludlow)


Butler,Rt.Hn.R.A. (Saffron Walden)
Henderson-Stewart, Sir James
Mott-Radclyffe, Sir Charles


Campbell, Sir David (Belfast, S.)
Hendry, Forbes
Nabarro, Gerald


Campbell, Gordon (Moray &amp; Nairn)
Hicks Beach, Maj, W.
Neave, Airey


Carr, Compton (Barons Court)
Hiley, Joseph
Nicholls, Sir Harmar


Channon, H. P. G.
Hill, Dr. Rt. Hon. Charles (Luton)
Nicholson, Sir Godfrey


Chataway, Christopher
Hill, Mrs. Eveline (Wythenshawe)
Noble, Michael


Chichester-Clark, R.
Hill, J. E. B. (S. Norfolk)
Nugent, Sir Richard


Clark, Henry (Antrim, N.)
Hinchingbrooke, Viscount
Oakshott, Sir Hendrie


Clark, William (Nottingham, S.)
Hirst, Geoffrey
Ormsby Gore, Rt. Hon. D.


Clarke, Brig. Terence (Portsmth, W.)
Hobson, John
Orr-Ewing, C. Ian


Cleaver, Leonard
Hocking, Philip N.
Osborn, John (Hallam)


Cole, Norman
Holland, Philip
Osborne, Cyril (Louth)


Cooper, A. E.
Hollingworth, John
Page, John (Harrow, West)


Cordeaux, Lt.-Col. J. K.
Hope, Rt. Hon. Lord John
Pannell, Norman (Kirkdale)


Cordle, John
Hopkins, Alan
Partridge, E.


Corfield, F. V.
Hornby, R. P.
Pearson, Frank (Clitheroe)


Costain, A. P.
Hornsby-Smith, Rt. Hon. Patricia
Peel, John


Coulson, J. M.
Howard, Hon. G. R. (St. Ives)
Percival, Ian


Courtney, Cdr. Anthony
Howard, John (Southampton, Test)
Peyton, John


Craddock, Sir Beresford
Hughes Hallett, Vice-Admiral John
Pickthorn, Sir Kenneth


Critchley, Julian
Hughes-Young, Michael
Pike, Miss Mervyn


Crosthwaite-Eyre, Col. O. E.
Hurd, Sir Anthony
Pilkington, Sir Richard


Crowder, F. P.
Hutchison, Michael Clark
Pitman, I. J.


Cunningham, Knox
Iremonger, T. L.
Pitt, Miss Edith


Curran, Charles
Irvine, Bryant Godman (Rye)
Pott, Percivall


Currie, G. B. H.
Jackson, John
Powell, Rt. Hon. J. Enoch


Dalkeith, Earl of
James, David
Price, David (Eastleigh)


Dance, James
Jenkins, Robert (Dulwich)
Price, H. A. (Lewisham, W.)


d'Avigdor-Goldsmid, Sir Henry
Jennings, J. C.
Prior, J. M. L.


Deedes, W. F.
Johnson, Dr. Donald (Carlisle)
Prior-Palmer, Brig. Sir Otho


de Ferranti, Basil
Johnson, Eric (Blackley)
Profumo, Rt. Hon. John


Digby, Simon Wingfield
Johnson Smith, Geoffrey
Proudfoot, Wilfred


Donaldson, Cmdr. C. E. M.
Jones, Rt. Hn. Aubrey (Hall Green)
Quennell, Miss J. M.


Doughty, Charles
Joseph, Sir Keith
Ramsden, James


Drayson, G. B.
Kaberry, Sir Donald
Rawlinson, Peter


du Cann, Edward
Kerby, Capt. Henry
Redmayne, Rt. Hon. Martin


Duncan, Sir James
Kerr, Sir Hamilton
Rees, Hugh


Duthie, Sir William
Kershaw, Anthony
Rees-Davies, W. R.


Eden, John
Kimball, Marcus
Renton, David


Elliot, Capt. Walter (Carshalton)
Kirk, Peter
Ridley, Hon. Nicholas


Elliott,R.W. (N'wc'stle-upon-Tyne,N.)
Kitson, Timothy
Ridsdale, Julian


Emery, Peter
Lagden, Godfrey
Rippon, Geoffrey


Emmet, Hon. Mrs. Evelyn
Lambton, Viscount
Roberts, Sir peter (Heeley)


Errington, Sir Eric
Lancaster, Col. C. G.
Robertson, Sir David


Erroll, Rt. Hon. F. J.
Langford-Holt, J.
Robson Brown, Sir William


Farey-Jones, F. W.
Leather, E. H. C.
Roots, William


Farr, John
Leavey, J. A.
Ropner, Col. Sir Leonard


Fell, Anthony
Lewis, Kenneth (Rutland)
Royle, Anthony (Richmond, Surrey)


Finlay, Graeme
Lilley, F. J. P.
Sandys, Rt. Hon. Duncan


Fisher, Nigel
Lindsay, Martin
Scott-Hopkins, James


Fletcher-Cooke, Charles
Linstead, Sir Hugh
Sharples, Richard


Foster, John
Litchfield, Capt. John
Shaw, M.


Fraser, Ian (Plymouth, Sutton)
Lloyd. Rt. Hon. Selwyn (Wirral)
Shepherd, William


Freeth, Denzil
Longbottom, Charles
Simon, Rt. Hon. Sir Jocelyn


Galbraith, Hon. T. G. D.
Longden, Gilbert
Skeet, T. H. H.


Gardner, Edward
Loveys, Walter H.
Smithers, Peter


George, J. C. (Pollok)
Low, Rt. Hon. Sir Toby
Smyth, Brig, Sir John (Norwood)


Gibson-Watt, David
Lucas-Tooth, Sir Hugh
Soames, Rt. Hon. Christopher


Glover, Sir Douglas
McAdden, Stephen
Spearman, Sir Alexander


Glyn, Dr. Alan (Clapham)
MacArthur, Ian
Speir, Rupert


Glyn, Sir Richard (Dorset, N.)
McLaren, Martin
Stanley, Hon. Richard


Godber, J. B.
McLaughlin, Mrs. Patricia
Stevens, Geoffrey


Goodhart, Philip
Maclay, Rt. Hon. John
Steward, Harold (Stockport, S.)


Goodhew, Victor
Maclean,SirFitzroy (Bute&amp;N.Ayrs.)
Stodart, J. A.


Gower, Raymond
Macleod, Rt. Hn. lain (Enfield, W.)
Stoddart-Scott, Col. Sir Malcolm


Grant, Rt. Hon. William
MacLeod, John (Ross &amp; Cromarty)
Studholme, Sir Henry


Grant-Ferris, Wg Cdr. R.
McMaster, Stanley R.
Summers, Sir Spencer (Aylesbury)


Green, Alan
Macmillan,Rt.Hn.Harold (Bromley)
Sumner, Donald (Orpington)


Gresham Cooke, R,
Macmillan, Maurice (Halifax)
Talbot, John E.


Grimston, Sir Robert
Macpherson, Niall (Dumfries)
Tapsell, Peter



Maddan, Martin








Taylor, sir Charles (Eastbourne)
Vane, W. M. F.
Williams, Dudley (Exeter)


Taylor, Edwin (Bolton, E.)
Vaughan-Morgan, Sir John
Williams, Paul (Sunderland, S.)


Taylor, W. J. (Bradford, N.)
Vickers, Miss Joan
Wills, Sir Gerald (Bridgwater)


Teeling, William
Vosper, Rt. Hon. Dennis
Wilson, Geoffrey (Truro)


Temple, John M.
Wakefield, Sir Wavell (St. M'lebone)
Wise, A. R.


Thatcher, Mrs. Margare'
Walker-Smith, Rt. Hon Sir Derek
Wolrige-Gordon, Patriok


Thomas, Peter (Conway)
Wall, Patrick
Woodhouse, C. M.


Thompson, Richard (Croydon, S.)
Ward, Dame Irene
Woodnutt, Mark


Thornton-Kemsley, Sir Colin
Watkinson, Rt. Hon. Harold
Woollam, John


Tiley, Arthur (Bradford, W.)
Watts, James
Worsley, Marcus


Tilney, John (Wavertree)
Webster, David
TELLERS FOR THE NOES:


Turner, Colin
Wells, John (Maidstone)
Mr. Edward Wakefield and


Tweedsmuir, Lady
Whitelaw, William
Colonel J. H. Harrison.


van Straubenzee, W. R.

BUSINESS OF THE HOUSE

Motion made, and Question put: —

That the Proceedings of the Committee of Ways and Means be exempted, at this day's Sit-

ting, from the provisions of Standing Order No. 1 (Sittings of the House).—[Mr. R. A. Butler.]

The House divided: Ayes 310, Noes 217.

Division No. 41.
AYES
[10.14 p.m.


Agnew, Sir Peter
Currle, G. B. H.
Hicks Beach, Maj. W.


Aitken, W. T.
Dalkeith, Earl of
Hiley, Joseph


Allan, Robert (Paddington, S.)
Dance, James
Hill, Dr. Rt. Hon. Charles (Luton)


Amery, Rt. Hon. Julian (Preston. N.)
d'Avigdor-Goldsmid, Sir Henry
Hill, Mrs. Eveline (Wythenshawe)


Ashton, Sir Hubert
Deedes, W. F.
Hill, J. E. B. (S. Norfolk)


Atkins, Humphrey
de Ferranti, Basil
Hirst, Geoffrey


Balniel, Lord
Digby, Simon Wingfield
Hobson, John


Barber, Anthony
Donaldson, Cmdr. C. E. M.
Hocking, Philip N.


Barlow, Sir John
Doughty, Charles
Holland, Philip


Barter, John
Drayson, G. B.
Hollingworth, John


Batsford, Brian
du Cann, Edward
Hope, Rt. Hon. Lord John


Baxter, Sir Beverley (Southgate)
Duncan, Sir James
Hopkins, Alan


Beamish, Col. Sir Tufton
Eden, John
Hornby, R. P.


Bennett, F. M. (Torquay)
Elliot, Capt. Walter (Carshalton)
Hornsby-Smith, Rt. Hon. Patricia


Bennett, Dr. Reginald (Gos &amp; Fhm)
Elliott,R. W. (N'wc'stle-upon-Tyne,N.)
Howard, Hon. G. R. (St. Ives)


Berkeley, Humphry
Emery, Peter
Howard, John (Southampton, Test)


Bevins, Rt. Hon. Reginald (Toxteth)
Emmet, Hon. Mrs. Evelyn
Hughes Hallett, Vice-Admiral John


Bidgood, John C.
Errington, Sir Eric
Hughes-Young, Michael


Biggs-Davison, John
Erroll, Rt. Hon. F. J.
Hurd, Sir Anthony


Bingham, R. M.
Farey-Jones, F. W.
Hutchison, Michael Clark


Birch, Rt. Hon. Nigel
Farr, John
Iremonger, T. L.


Bishop, F. P.
Fell, Anthony
Irvine, Bryant Godman (Rye)


Black, Sir Cyril
Finlay, Graeme
Jackson, John


Bossom, Clive
Fisher, Nigel
James, David


Bourne-Arton, A.
Fletcher-Cooke, Charles
Jenkins, Robert (Dulwich)


Box, Donald
Foster, John
Jennings, J. C.


Boyd-Carpenter, Rt. Hon. John
Fraser, Ian (Plymouth, Sutton)
Johnson, Dr. Donald (Carlisle)


Boyle, Sir Edward
Freeth, Denzil
Johnson, Eric (Blackley)


Braine, Bernard
Galbraith, Hon. T. G. D.
Johnson Smith, Geoffrey


Brewis, John
Gardner, Edward
Jones, Rt. Hn. Aubrey (Hall Green)


Bromley-Davenport,Lt.-Col.Sir Walter
George, J. C. (Pollok)
Joseph, Sir Keith


Brooke, Rt. Hon. Henry
Gibson-Watt, David
Kaberry, Sir Donald


Brooman-White, R.
Glover, Sir Douglas
Kerby, Capt. Henry


Browne, Percy (Torrington)
Glyn, Dr. Alan (Clapham)
Kerr, Sir Hamilton


Bryan, Paul
Glyn, Sir Richard (Dorset, N.)
Kershaw, Anthony


Bullard, Denys
Godber, J. B.
Kimball, Marcus


Bullus, Wing Commander Eric
Goodhart, Philip
Kirk, Peter


Butcher, Sir Herbert
Goodhew, Victor
Kitson, Timothy


Butler, Rt.Hn.R.A. (Saffron Walden)
Gower, Raymond
Lagden, Godfrey


Campbell, Gordon (Moray &amp; Nairn)
Grant, Rt. Hon. William
Lambton, Viscount


Channon, H. P. G.
Grant-Ferris, Wg Cdr. R.
Lancaster, Col. C. G.


Chataway, Christopher
Green, Alan
Langford-Holt, J.


Chichester-Clark, R,
Gresham Cooke, R.
Leather, E. H. C.


Clark, Henry (Antrim, N.)
Grimston, Sir Robert
Leavey, J. A.


Clark, William (Nottingham, S.)
Grosvenor, Lt.-Col. R. G.
Lewis, Kenneth (Rutland)


Clarke, Brig. Terence (Portsmth, W.)
Gurden, Harold
Lilley, F. J. P.


Cleaver, Leonard
Hall, John (Wycombe)
Lindsay, Martin


Cole, Norman
Hamilton, Michael (Wellingborough)
Linstead, Sir Hugh


Cooper, A. E,
Harris, Frederic (Croydon, N.W.)
Litchfield, Capt. John


Cordeaux, Lt.-Col. J. K.
Harris, Reader (Heston)
Lloyd, Rt. Hon. Selwyn (Wirral)


Cordle, John
Harrison, Brian (Maldon)
Longden, Gilbert


Corfield, F. V.
Harvey, Sir Arthur Vere (Macclesf'd)
Loveys, Walter H,


Costain, A. P.
Harvey, John (Walthamstow, E.)
Low, Rt. Hon. Sir Toby


Coulson, J. M.
Harvie Anderson, Miss
Lucas-Tooth, Sir Hugh


Courtney, Cdr. Anthony
Hastings, Stephen
McAdden, Stephen


Craddock, Sir Beresford
Hay, John
MacArthur, Ian


Critchley, Julian
Heald, Rt. Hon. Sir Lionel
McLaren, Martin


Crosthwalte-Eyre, Col. O. E.
Heath, Rt. Hon. Edward
McLaughlin, Mrs. Patricia


Curran, Charles
Henderson, John (Cathoart)
Maclay, Rt. Hon. John


Crowder, F. P.
Henderson-Stewart, Sir James
Maclean, SirFitzroy (Bute&amp;N.Ayrs.)


Cunningham, Knox
Hendry, Forbes
Macleod, Rt. Hn. lain (Enfield, W.)




MacLeod, John (Ross &amp; Cromarty)
Pott, Percivall
Talbot, John E.


McMaster, Stanley R.
Powell, Rt. Hon. J. Enoch
Tapsell, Peter


Macmillan,Rt.Hn.Harold (Bromley)
Price, David (Eastleigh)
Taylor, Sir Charles (Eastbourne)


Macmillan, Maurice (Halifax)
Price, H. A. (Lewisham, W.)
Taylor, Edwin (Bolton, E.)


Macpherson, Niall (Dumfries)
Prior, J. M. L.
Taylor, W. J. (Bradford, N.)


Maddan, Martin
Prior-Palmer, Brig. Sir Otho
Teeling, William


Maitland, Sir John
Profumo, Rt. Hon. John
Temple, John M.


Manningham-Buller, Rt. Hn. Sir R.
Proudfoot, Wilfred
Thatcher, Mrs. Margaret


Markham, Major Sir Frank
Quennell, Miss J. M.
Thomas, Leslie (Canterbury)


Marlowe, Anthony
Ramsden, James
Thomas, Peter (Conway)


Marshall, Douglas
Rawlinson, peter
Thompson, Richard (Croydon, S.)


Marten, Neil
Redmayne, Rt. Hon. Martin
Thornton-Kemsley, Sir Colin


Mathew, Robert (Honiton)
Rees, Hugh
Tiley, Arthur (Bradford, W.)


Matthews, Gordon (Meriden)
Rees-Davies, W. R.
Tilney, John (Wavertree)


Maudling, Rt. Hon. Reginald
Renton, David
Turton, Rt. Hon, R. H.


Mawby, Ray
Ridley, Hon. Nicholas
Tweedsmuir, Lady


Maxwell-Hyslop, R. J.
Ridsdale, Julian
Vane, W. M. F.


Maydon, Lt.-Cmdr. S. L. C.
Rippon, Geoffrey
Vaughan-Morgan, Sir John


Mills, Stratton
Roberts, Sir Peter (Heeley)
Vickers, Miss Joan


Montgomery, Fergus
Robertson, Sir David
Vosper, Rt. Hon. Dennis


More, Jasper (Ludlow)
Robson Brown, Sir William
Wakefield, Sir Wavell (St. M'lebone)


Nabarro, Gerald
Roots, William
Walker-Smith, Rt. Hon. Sir Derek


Neave, Airey
Ropner, Col. Sir Leonard
Wall, Patrick


Nicholls, Sir Harmar
Royle, Anthony (Richmond, Surrey)
Ward, Dame Irene


Nicholson, Sir Godfrey
Sandys, Rt. Hon. Duncan
Watkinson, Rt. Hon. Harold


Noble, Michael
Scott-Hopkins, James
Watts, James


Nugent, Sir Richard
Sharples, Richard
Webster, David


Oakshott, Sir Hendrie
Shaw, M.
Wells, John (Maidstone)


Ormsby Gore, Rt. Hon. D.
Shepherd, William
Whitelaw, William


Orr-Ewing, C. Ian
Simon, Rt. Hon. Sir Jocelyn
Williams, Dudley (Exeter)


Osborn, John (Hallam)
Skeet, T. H. H.
Williams, Paul (Sunderland, S.)


Osborne, Cyril (Louth)
Smithers, Peter
Wills, Sir Gerald (Bridgwater)


Page, John (Harrow, West)
Smyth, Brig. Sir John (Norwood)
Wilson, Geoffrey (Truro)


Pannell, Norman (Kirkdale)
Soames, Rt. Hon. Christopher
Wise, A. R.


Partridge, E,
Spearman, Sir Alexander
Wolrige-Gordon, Patrick


Pearson, Frank (Clitheroe)
Speir, Rupert
Woodhouse, C. M


Peel, John
Stanley, Hon. Richard
Woodnutt, Mark


Percival, Ian
Stevens, Geoffrey
Woollam, John


Peyton, John
Steward, Harold (Stockport, S.)
Worsley, Marcus


Pike, Miss Mervyn
Stodart, J. A.
TELLERS FOR THE AYES:


Pilkington, Sir Richard
Stoddart-Scott, Col. Sir Malcolm
Mr. Edward Wakefield and


Pitman, I. J.
Studholme, Sir Henry
Colonel J. H. Harrison.


Pitt, Miss Edith
Summers, Sir Spencer (Aylesbury)




Sumner, Donald (Orpington)





NOES


Abse, Leo
Davies, Ifor (Gower)
Hayman, F. H.


Ainsley, William
Davies, S. O. (Merthyr)
Healey, Denis


Albu, Austen
Deer, George
Henderson, Rt.Hn.Arthur (Rwly Regis)


Allaun, Frank (Salford, E.)
de Freitas, Geoffrey
Herbison, Miss Margaret


Allen, Scholefield (Crewe)
Delargy, Hugh
Hewitson, Capt. M.


Awbery, Stan
Dempsey, James
Hill, J. (Midlothian)


Bacon, Miss Alice
Diamond, John
Hilton, A. V.


Balrd, John
Donnelly, Desmond
Holman, Percy


Baxter, William (Stirlingshire, W.)
Driberg, Tom
Houghton, Douglas


Beaney, Alan
Edelman, Maurice
Howell, Charles A.


Bellenger, Rt. Hon. F. J.
Edwards, Rt. Hon. Ness (Caerphilly)
Hoy, James H.


Bence, Cyril (Dunbartonshire, E.)
Edwards, Robert (Bilston)
Hughes, Cledwyn (Anglesey)


Blackburn, F,
Edwards, Walter (Stepney)
Hughes, Emrys (S. Ayrshire)


Blyton, William
Evans, Albert
Hughes, Hector (Aberdeen, N.)


Boardman, H.
Fernyhough, E.
Hunter, A. E.


Bowden, Herbert W. (Leics, S.W.)
Finch, Harold
Hynd, John (Attercliffe)


Bowen, Roderic (Cardigan)
Fitch. Alan
Irvine, A. J. (Edge Hill)


Bowles, Frank
Fletcher, Eric
Irving, Sydney (Dartford)


Braddock, Mrs. E, M.
Foot, Dingle (Ipswich)
Janner, Sir Barnett


Brockway, A. Fenner
Foot, Michael (Ebbw Vale)
Jay, Rt. Hon. Douglas


Broughton, Dr. A. D. D.
Forman, J. C.
Jeger, George


Brown, Alan (Tottenham)
Fraser, Thomas (Hamilton)
Jenkins, Roy (Stechford)


Brown, Rt. Hon. George (Belper)
Gaitskall, Rt. Hon. Hugh
Johnson, Carol (Lewisham, S.)


Butler, Herbert (Hackney, C.)
Galpern, Sir Myer
Jones, Rt. Hn. A. Creech (Wakefield)


Butler, Mrs. Joyce (Wood Green)
George, LadyMeganLloyd (C'rm'rth'n)
Jones, Dan (Burnley)


Callaghan, James
Ginsburg, David
Jones, Jack (Rotherham)


Castle, Mrs. Barbara
Gooch, E. G.
Jones, J. Idwal (Wrexham)


Chetwynd, George
Gordon Walker, Rt. Hon. P. C.
Jones, T. W. (Merioneth)


Cliffe, Michael
Gourlay, Harry
Kelley, Richard


Collick, Percy
Greenwood, Anthony
Kenyon, Clifford


Corbet, Mrs. Freda
Grey, Charles
King, Dr. Horace


Craddock, George (Bradford, S.)
Griffiths, Rt. Hon. James (Llanelly)
Lawson, George


Cronin, John
Griffiths, W. (Exchange)
Ledger, Ron


Crosland, Anthony
Gunter, Ray
Lee, Frederick (Newton)


Crossman, R. H. S.
Hale, Leslie (Oldham, W.)
Lee, Miss Jennie (Cannock)


Cullen, Mrs. Alice
Hall, Rt. Hon. Glenvil (Colne Valley)
Lever, L. M. (Ardwick)


Darling. George
Hamilton, William (West Fife)
Lewis, Arthur (West Ham. N.)


Davies, G. Elfed (Rhondda, E.)
Hannan, William
Lipton, Marcus


Davies. Harold (Leek)
Hart, Mrs. Judith
Loughlin, Charles







Mabon, Dr. J. Dickson
Peart, Frederick
Symonds, J. B.


McCann, John
Pcntland, Norman
Taylor, Bernard (Mansfield)


MacColl, James
Plummer, Sir Leslie
Thomas, George (Cardiff, W.)


McInnes, James
Prentice, R. E.
Thompson, Dr. Alan (Dunfermline)


McKay, John (Wallsend)
Price, J. T. (Westhoughton)
Thomson, G. M. (Dundee, E.)


Mackie, John
Probert, Arthur
Thornton, Ernest


MacMillan, Malcolm (Western Isles)
Proctor, W. T.
Thorpe, Jeremy


Mallalieu, E. L. (Brigg)
Pursey, Cmdr. Harry
Timmons, John


Mallalieu,J.P.W. (Huddersfield,E.)
Rankin, John
Tomney, Frank


Manuel, A. C.
Redhead, E. C.
Ungoed-Thomas, Sir Lynn


Mapp, Charles
Reynolds, G. W.
Wade, Donald


Marquand, Rt. Hon. H. A.
Roberts, Goronwy (Caernarvon)
Wainwright, Edwin


Marsh, Richard
Robinson, Kenneth (St. Pancras, N.)
Watkins, Tudor


Mason, Roy
Ross, William
Wells, William (Walsall, N.)


Mayhew, Christopher
Silverman, Julius (Aston)
White, Mrs. Eirene


Mellish, R. J.
Silverman, Sydney (Nelson)
Whitlock, William


Mendelson, J. J.
Skeffington, Arthur
Wilcock, Group Capt. C. A. B.


Millan, Bruce
Slater, Mrs. Harriet (Stoke, N.)
Wilkins, W. A.


Milne, Edward J.
Slater, Joseph (Sedgefield)
Willey, Frederick


Mitchison, G. R.
Small, William
Williams, D. J. (Neath)


Monslow, Walter
Snow, Julian
Williams, Ll. (Abertillery)


Morris, John
Sorensen, R. W.
Williams, W. R. (Openshaw)


Mulley, Frederick
Soskice, Rt. Hon. Sir Frank
Willis, E. G. (Edinburgh, E.)


Neal, Harold
Spriggs, Leslie
Wilson, Rt. Hon. Harold (Huyton)


Oram, A. E.
Steele, Thomas
Winterbottom, R. E,


Oswald, Thomas
Stewart, Michael (Fulham)
Woodburn, Rt. Hon. A.


Owen, Will
Stonehouse, John
Woof, Robert


Padley, W. E.
Stones, William
Wyatt, Woodrow


Pannell, Charles (Leeds, W.)
Strachey, Rt. Hon. John
Yates, Victor (Ladywood)


Pargiter G. A.
Strauss, Rt. Hn. G. R. (Vauxhall)
Zilliacus, K.


Parker, John (Dagenham)
Stross,Dr.Barnett (Stoke-on-Trent,C.)
TELLERS FOR THE NOES:


Parkin, B. T. (Paddington, N.)
Swain, Thomas
Mr. Rogers and Mr. Short.


Pavitt, Laurence
Swingler, Stephen



Pearson, Arthur (Pontypridd)
Sylvester, George

Orders of the Day — WAYS AND MEANS

Considered in Committee.

[Sir GORDON TOUCHE in the Chair]

NATIONAL HEALTH SERVICE CONTRIBUTIONS

10.25 p.m.

The Financial Secretary to the Treasury (Sir Edward Boyle): I beg to move,
1. That the rates of National Health Service contributions be increased by substituting the rates specified in the Table set out below for the rates set out in the Schedule to the National Health Service Contributions Act, 1958.
2. That it is expedient to amend the National Health Service Contributions Act, 1957—

(a) so that enactments relating to national insurance passed subsequently to the National Insurance Act, 1956, shall be deemed to have been included among the National Insurance Acts referred to in the said Act of 1957;
(b) so that the provisions of the said Act of 1957 as to the expenses of the Minister of Pensions and National Insurance shall be deemed to have applied to the expenses of other government departments and to have included provision in respect of accruing liabilities for pensions and other payments and in respect of the use of premises belonging to the Crown; and
(c) so as to authorise the Treasury, instead of the Minister of Health and the Secretary of Stale, to make regulations under the said Act of 1957.

3. That there be paid into the Exchequer any increase in the sums so payable by virtue of the said Act of 1957, being an increase attributable to the increases in rates of contributions and the amendments referred to in the preceding provisions of this Resolution.
4. That it is expedient to make provision for other matters incidental or supplementary to the matters aforesaid.

TABLE


Description of person
Weekly rate of contribution



s.
d.


1. Employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment
2
8½


2. Employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment
2
0½

Description of person
Weekly rate of contribution



s.
d.


3. Employed boys and girls under (he age of 18
1
4½


4. Employers

7½


5. Self-employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment
2
10


6. Self-employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment
2
2


7. Self-employed boys and girls under the age of 18
1
6


8. Non-employed men between the ages of 18 and 65
2
10


9. Non-employed women between the ages of 18 and 60
2
2


10. Non-employed boys and girls under the age of 18
1
6

We now come to the increase in the National Health Service contribution of 1s., and I hope that it will be with the agreement of the Committee, after a not Wholly uncontroversial debate earlier this evening, if I confine myself in this speech to an exposition of the Government's proposals and do not indulge in a great deal of argument or justification. [Interruption.] There will be plenty of opportunity for more argumentative discussion in which I and others will be delighted to take part, but, solely from the point of view of the convenience of the Committee, I think that on this occasion hon. Members would prefer a speech mainly of exposition. [HON. MEMBERS: "No."] The Government have always accepted—

Mr. Richard Marsh: On a point of order. Is it in order for the Financial Secretary to rise to speak on a controversial issue and to inform the Committee as he starts that he has no intention of putting the Government's argument in justification?

The Chairman (Sir Gordon Touche): He can make a speech as he wishes.

Sir E. Boyle: The Government have always accepted the principle, embodied in the original National Insurance Act, which hon. Members opposite—

Mr. William Ross: Mr. William Ross (Kilmarnock) rose —

Sir E. Boyle: —including the hon. Member for Kilmarnock (Mr. Ross)—

Mr. Ross: On a point of order. In his opening remarks the hon. Gentleman said that he intended to present his case


in some way which was convenient to the Committee. It was obviously not convenient to this side of the Committee. Can the hon. Member be permitted to continue in that way?

The Chairman: That is not a point of order.

Mr. Sydney Silverman: Further to that point of order. In defence of the hon. Gentleman, if he has no argument in justification, how, as a matter of order, can he possibly advance one?

The Chairman: The hon. Member knows perfectly well that that is not a point of order.

Mr. Emrys Hughes: On a point of order. May I ask for your guidance, Sir Gordon? Do these proposals apply to Scotland? If so, where are the Scottish Ministers?

The Chairman: That is not a matter for me.

Sir E. Boyle: The Government—

Mr. A. C. Manuel: On a point of order. My hon. Friend the Member for South Ayrshire (Mr. Emrys Hughes) asked whether this increase in contributions would apply to Scotland. I think that we must have an answer to that and have a Scottish Minister on the Government Front Bench, and—

The Chairman: Order. That is not a point of order.

Sir E. Boyle: The Government have accepted the principle, to which both parties are committed—

Mr. Emrys Hughes: On a point of order. I asked for your guidance, Sir Gordon. I asked only whether this increase applied to Scotland.

The Chairman: That is not a matter for me.

Sir E. Boyle: —that it is reasonable to make some contribution income available for financing a part of the Health Service. As the Committee will be aware, under the 1946 Insurance Act the contribution towards the Health Service was £40 million. In 1957, and

again in 1958, rather than reduce the Service, the Government decided to raise the contribution. In 1957, the total contribution was raised to 1s. 8d. and, in 1958, to 2s. 4d. It will have remained at that higher level for three years, and during this period the gross cost of the National Health Service has increased from £675 million, which was the estimate for 1958–59, to approximately £850 million, which is the estimate for the forthcoming financial year.

10.30 p.m.

The annual yield after the 1958 increase was £112 million. We propose further increases in contribution, as I will explain in a moment, which will raise the total net yield, after allowing for the expenses of collection, to £161 million in a full year, which means an increase of £49 million. It is the Government's proposal to bring the new rates of contribution into effect on 3rd July, if these proposals are approved by Parliament, so that the yield in the first year will be £148 million.

This increase of £49 million in the contribution over three years must, in all fairness, be contrasted with the increase of £175 million in the gross cost of the Service, and I must make this point for comparison, that we are aiming to cover, as a result of increasing the contribution, less than one-third of the rise in total expenditure since the last contribution increase.

Now I come to the details of the Government's proposals. The proposals are, first to increase the contributions by 10d. for an employed man, 8d. for a woman and 6d. for a boy and girl, with 2d. on all contributions from employers. The result will be that the employed man will pay a total of 2s. 8½ d, a week and his employer 7½ d. The total new contribution rate will be £7 a year. In fact, the employed man will have to pay only 2s. a week more than in 1948.

The increases for the self-employed and non-employed will be 8d. for a man, 6d. for a woman and 4d. for a boy and girl. As a result, for example, the self-employed man will pay 2s. 10d. At this level the self-employed man will be paying rather more—1½ d. more, in fact—than the man in employment, but rather less than the total contribution for the employed man when we take into account the employer contribution as well,


and the Government feel that this is about right. When the scheme was originally started, the self-employed man paid as much as a total contribution on behalf of the employed man. If that principle had been continued a self-employed man would, under our new proposals, be paying 3s. 4d. instead of 2s. 10d.

We think that there is a case for affording some marginal relief to the self-employed man, but the relief should not be such that his level of contribution is reduced to that borne by the employed man personally. We do not want to get too far away from the original concept of the 1946 National Insurance Act, that the Health Service was entitled to receive as much altogether in respect of a self-employed person as in respect of an employed person since it provided the same benefits for all. Furthermore, the employer's contribution is part of what have come to be called "fringe benefits", and the payment of this contribution may have a marginal effect on an employer's ability to pay a higher wage.

We also propose, by the terms of this Resolution, and in the Bill which the Government hope will be founded on it, to take the opportunity to make one or two amendments to the 1957 Act, notably to substitute an up-to-date definition of liability to pay the contribution, for a definition which, with the passage of events, has now become out of date, and to make the position clear on this question of expenses of contribution, so that as from the passing of the 1957 Act the full costs of collection—for instance, including charges for staff superannuation and accommodation—are to be treated as properly deductable from the yield before the net amount is paid over in aid of the Health Service Votes.

This is only an accounting detail. I should like to emphasise that it has no effect at all on the contribution levied from the contributor, nor on the total expenditure of the Health Service. But we are assured by our legal advisers that this is putting right a matter which has become wrong.

Mr. Eric Fletcher: Is this proposal intended to be a retrospective operation?

Sir E. Boyle: Yes, it is. This is exactly the form of retrospective operation to which during our discussions on the last Finance Bill the Government said they had no objection. It is stating the law as everyone had hitherto supposed it to be. It is ensuring that the law is in fact what it had been supposed to be.

Mr. Hector Hughes: The hon. Gentleman is galloping through his speech on this important subject as though it did not matter. Will he treat it with more respect and proceed more slowly so that we can follow what he is saying?

Sir E. Boyle: I had completed what I had to say, and I was about to resume my seat. I apologise if I have gone too fast for the hon. and learned Gentleman. The House heard from me earlier this evening, and we shall have many more opportunities to discuss this. I therefore thought that I would content myself with a relatively brief explanation.

Mr. Douglas Houghton: The hon. Gentleman was much more at ease in explaining these proposals than he was a few moments ago in defending them. I am sure that he need not hesitate to give the Committee the justification for these proposals. It is very considerate of the hon. Gentleman to study the convenience of the Committee, but I assure him that my right hon. and hon. Friends are entirely at his disposal. If a little later he feels moved to return to that part of his speech which he omitted, we shall be very glad to hear it.
What the hon. Gentleman did for the most part of his speech was to explain some of the detail which would be more suitable to the Committee stage of the Bill. What we wish to do in the time available is to consider some of the fundamental aspects of the proposals. We on these benches deeply regret that this House rejected the Motion of censure on the Government for introducing these proposals along with others connected with the Health Service. Had that Motion been carried, it would have swept away the whole apparatus of charges and contributions, and, of course, the Government would have been swept away with it. But the House has decided that we must now give attention to the legislative


mechanics of the proposals which the Minister of Health announced the other day.
This Motion is a sort of slipway down which the Bill will be launched, we expect next week. We are against the Bill, so we are against the slipway. We shall oppose this, and we shall oppose the Bill. We shall pray against Orders; we shall, in fact, oppose the whole lot from beginning to end. That gives the benches opposite fair warning of what is coming to them.
An important question which the Committee ought to consider for a few moments is whether taxation should be introduced in this way and at this time before the Budget. There will be no dispute now that these contributions are a tax. The Minister this afternoon referred to them as a sort of poll tax. In any case, we have the authority of the Sunday Times, and we also notice in the Motion that the proceeds of these contributions will not go into the National Insurance Fund but will be paid over to the Exchequer. So these contributions have every appearance of being a tax.
The proceeds of this tax amount to almost £50 million in a full year, and we are entitled to ask the Government whether additional taxation should be levied in advance of the Budget, when we can see the whole conspectus of the national economy and the outturn of the year's revenue and expenditure, and see how the Chancellor proposes to meet the Exchequer obligations for the coming year. Before we even consider the proposed increases in National Health tax, we should like to know, for example, what the Chancellor is going to do about Surtax. We should also like to know whether he will give concessions on Schedule A Income Tax amounting to about £30 million. How is the Chancellor going to deploy the national finances? That is a very important question in considering this form of taxation.
I submit that no one would think of imposing additional taxation on motor vehicles in advance of the Budget on the ground that the cost of road building was proving too much for the Exchequer to bear, yet that principle is followed

in connection with these proposals. This has happened twice before. In 1958, the proposed increases in National Health contributions were announced in March, before the Budget. In 1957, the Government announced their intention of imposing charges for the first time before the Budget, although it so happened that the Second Reading of the Bill took place on 8th May—on the day following the Second Reading of the Finance Bill. It is a coincidence that the right hon. Gentleman who was then Financial Secretary moved the first Ways and Means Resolution imposing the National Health contributions in 1957.
It is not without interest that in 1957, when additional revenue from National Health contributions was being obtained—

Mr. E. Fernyhough: On a point of order, Mr. Deputy-Speaker. Can you ask the Patronage Secretary to conduct his conversation outside the Chamber?

The Chairman: That is not a point of order for me.

Mr. S. Silverman: Are you really ruling, Mr. Deputy-Speaker, that if hon. and right hon. Members conduct private conversations in the Chamber in so loud a voice as to prevent us from hearing the pearls of wisdom coming from either side of the House, it is not a point of order for you?

The Chairman: That situation did not arise. I did not hear the Patronage Secretary's voice at all.

Mr. Houghton: I was saying that in 1957, when the first National Health Service contributions were introduced on the ground that the cost of the Health Service was growing too heavy for the Exchequer to bear, at the same time one Income Tax concession alone was the equivalent of half the imposition then being brought in on the National Health Service. The earned income relief of two-ninths was increased on the higher incomes, from £2,000 to £4,000 a year, a new earned income relief of one-ninth was introduced on earned incomes from £4,000 to £10,000 a year, at the same time as the imposition of the first National Health Service contributions.

10.45 p.m.

In 1958, we had a further increase in the National Health Service contribution. It is true that in the Budget of 1958 no such spectacular concessions were made in the sphere of taxation because 1958 did not happen to be an election year. But in 1959, the year after the introduction of still higher contributions, tax reliefs totalling approximately £300 million were given in the Budget of that year. Naturally, therefore, at a time when we are asked to assent to a very sharp increase in the National Health contribution, we should like to know what tax concessions the Chancellor is going to make in his Budget in a few weeks time. Perhaps the Financial Secretary can give us some assurance that this year's increases in the contributions will not be accompanied by substantial tax reductions.

Sir Hugh Lucas-Tooth: Did the hon. Gentleman vote against any of these tax reductions, or did any Members of his party?

Mr. Houghton: What we did do was to vote against the National Health Service contribution increase. Hon. and right hon. Gentlemen opposite voted in favour of an additional contribution and in favour of reduced taxation at the same time, because, apparently, they believed with the then Minister of Health that the growing burden of the cost of the National Health Service was more than the Exchequer could be expected to bear; and, presumably, that is the foundation of the proposals which are before us at the present time.
The first thing we have established is that this is a tax. The second thing we have done is to criticise the imposition of additional taxation before the Budget and without knowing the general contours of the financial situation and Chancellor's intentions.

Sir Douglas Glover: The hon. Gentleman has referred about four times to the enormity of doing something before the Budget. I remember that the hon. Gentleman was in favour of the Chancellor altering the rates of Purchase Tax before Budget because it was retarding trade. If a reduction in that way is supported, why is this not supported?

Hon. Members: This is an increase.

Mr. Houghton: The trouble with hon. Gentlemen opposite is that first they see things upside down, and secondly, they are so insensitive that it is necessary to repeat four times the enormities of their conduct, otherwise it does not register with them at all.

Mr. S. Silverman: It does not anyway.

Mr. Houghton: The next thing we have to consider is whether the new contributions are a fair tax. Listening to the Minister of Health earlier, I thought he seemed to stress the fact that the ratio between the flat-rate contributions and earnings in 1946 was very little different from the ratio between the new higher rate of contribution and earnings today. I see no merit in that comparison. What the Minister was surely suggesting was that the 1946 standards of social services taxation should be permanently maintained. That is a curious doctrine, because in no other field of taxation have the 1946 standards been maintained. I really could not understand the force of the point he was making.
He also referred to the proportion which contributions were to find towards the total expenditure of the National Health Service. He said that in 1946 it was 21 per cent. and in 1961 it would be 16 per cent. and there seemed therefore to be some merit in that too. I do not acopt that doctrine either. There is no comfort whatever to the benches opposite, either in the Beveridge Report or what has happened since, to the belief that this kind of ratio should be permanently maintained—none at all. In fact, Beveridge referred in his Report to the provisional nature of his own suggestions and said that obviously they would have to be reviewed in the course and in the light of experience. We cannot see that there is any merit in the Government view that we should maintain the ratio between the flat rate contribution and earnings or maintain the ratio between the total yield of contributions and the gross cost of the National Health Service.
Let us look at another aspect of this as a form of taxation. The new and high flat rate contribution from 3rd July, taking into account the National Insurance contribution as well, will be 10s. 7d. a week for a man. That is £44 4s. a


year in tax. The curious thing is that 10s. 7d. in a flat rate contribution of this kind is equivalent and no more than equivalent to the amount of Income Tax that is paid by a single man on £9 10s. a week, or a married man with no children on £12 a week, a married man with one child not over 11 on £14 a week, or a married man with two children not over 11 on £16 a week. In other words, it is levying on the workers a flat rate tax in many cases in excess of the amount of Income Tax we deem it equitable for them to pay. If we look at the graduated contribution on top of the flat rate contribution, we find that the amount which will be paid by workers in the various categories of incomes and differences of domestic circumstances will be several shillings higher than the amount of tax which they are called upon to pay.
In our submission, this form of taxation is likely to be more inflationary than other forms of direct or even indirect taxation. These are a direct stimulus to wage demands, and the first forewarning of them has already been given. We should bear in mind, in looking at this Ways and Means Resolution, that this contribution will have been increased by 100 per cent. since 1957 and doubled in three years. I think that in no other respect has there been a doubling of imposts of this kind.
Finally, in considering this Resolution, we are entitled to ask whether it is really necessary. Time and again throughout this debate and in previous debates which I have heard with care in recent days we have had this choice placed before us as if there were no other. The choice put before us is this, either we limit the Service or adjust the finances. That is the choice every time, and the Minister has defended what he is doing on the ground that it is indispensable to the expansion of the Health Service which he wishes to see.

Brigadier Terence Clarke: Who started this form of taxation?

Mr. Houghton: This form of taxation was started by the Conservative Government in 1957. When we consider the Bill, we shall go into this question of who started it and how it was started, because, it is about time that that ghost

was laid—and it will be laid. When the time comes, I shall be able to quote from the Beveridge Report, going back to the conditions in which Beveridge first suggested that a grant-in-aid should be given from the National Insurance Fund to the National Health Service. But he said nothing about keeping the same ratio between contributions and the total cost, as the Government are apparently suggesting that it should be kept.

Brigadier Clarke: He had no responsibility. Who started the taxation?

Mr. Houghton: We have heard little of the hon. and gallant Member of late. His sepulchral tones have been missed in the House. He will have an opportunity later, for as long as he cares to speak, to elaborate any point which he wishes to raise.
I must come back to the choice which the Government put before the House and the Committee when making proposals such as those contained in the Ways and Means Resolution. I refer to the kind of incantation which was first started by the right hon. Member for Runcorn (Mr. Vosper), then Minister of Health, when he was speaking on this matter on 8th May, 1957. After referring to the rising cost of the Health Service, he said that a rise from 72 per cent. to 80 per cent. of the gross cost falling on the Exchequer was, the Government had decided, too heavy a burden for the taxpayer reasonably to be asked to bear. His words were,
more than the taxpayer can reasonably be expected to bear."—[OFFICIAL REPORT, 8th May, 1957; Vol. 569, c. 989].
What is the difference between the taxpayer and the contributor under the National Health Service? They are both people who pay a form of taxation. These are both forms of taxation. The Financial Secretary to the Treasury suggested earlier that if public expenditure is hived off from the liability of the Exchequer, then in some way or other it ceases to be public expenditure. But it is public expenditure all the time. This money is going into the Health Service. It will be spent by the Health Service. It will be just as much for the Health Service as the money which it receives from the Exchequer.
This curious approach to the question of public expenditure shows a split personality. What the hon. Member means


is, "We know that it will be public expenditure just the same, we know that it will be taxation just the same, but how differently it will be distributed. It will mean that the lower income groups will pay in this contribution an amount out of proportion to the direct taxation which is levied upon them under the Income Tax system". By that means the Government will be able to lower the charge on the higher income groups and to lower taxation on the very rich and on others who could well afford to continue to pay a full measure to the Exchequer for the National Health Service.
The real test is not the choice between the limitation of the Service and the adjustment of the finances. The real test is whether the expenditure on the Health Service can be accommodated within our national resources and also within the scope of our normal system of taxation, without undue burden upon the taxpayers generally. If the burdens are too heavy for the taxpayers to bear, they are too heavy for the contributors to bear. That is what the Financial Secretary never seems to appreciate.
There will be time enough to pursue these arguments and more when we come to the Bill. My hon. Friends will have more to say. Unlike the Financial Secretary, I have deployed enough of the arguments against the Resolution to justify our voting against it in due time.

11.0 p.m.

Mr. A. Woodburn: I welcome the proposals for increasing hospital expenditure and improving hospitals. I wish that those proposals went even further.
As the Financial Secretary said, in measuring capital expenditure one has to divide the capacity of the country by different items. If one item is increased, unless the total capacity is increased it must mean a readjustment in other cases. I do not quarrel with that. It was because of that fact that the hospital programme suffered very sadly in the early years after the war. The hospital building programme had to be restricted because of the demand for housing, schools and other urgent priorities. I have no objection to that. Any Government must obviously take that step.
However, I was rather disappointed when the Financial Secretary confused expenditure by the Government and expenditure by the nation. It is curious reasoning to suggest that, merely because the Government shoves expenditure off their plate on to somebody else's plate, that is economising for the country as a whole.
The difficulty the Minister of Health has is that the overwhelming bulk of the National Health Service expenditure is on items with which he cannot interfere. Salaries, wages, nurses' conditions, and conditions of hours and service, are all negotiated outwith his control. This is where he must vie with his colleagues. If the Government want every Department to make a cut, the Minister of Health has no play in the Service, except in the relatively small items such as prescriptions and odd things on the tail end of the Service.
If every Department were ordered to cut its expenditure by 5 per cent., the Minister of Health would have to cut his expenditure almost entirely by wiping out the free prescriptions and free services for patients. The patient would have to carry the whole burden, because the Minister could not cut salaries.
This is one of the problems the Government sometimes face. My right hon. and hon. Friends and I faced it when we were in office. Every Department wants all its colleagues to share in the economies, but the National Health Service cannot do that, because the main bulk of its expenditure is on salaries and conditions.
During the period the Labour Party was in office the cost of the National Health Service rose. That was because when we took over nurses' conditions were deplorable. Hospital supplies were in a deplorable condition. One of the best hospitals in the country had completely out of date X-ray apparatus. It was only thanks to the disposal of war surplus goods that we were able to give hospitals decent equipment in the early days of the Service. There is, therefore, no question that we had at once to improve the nurses' conditions. As a result, the cost of the Service went up quite rapidly.
Today, the cost of the Service is rising rapidly because the Minister of Health has been compelled to give the doctors a very substantial increase, and the nurses' conditions have had to be improved—their conditions will have to be still further improved if the Service is to justify itself in future. Not even yet are we able to give the nurses the conditions that women in other services get, and if we restrict the Service to a ceiling we shall have to restrict the improvement in the nurses' conditions, and so run the risk of crippling the Service through lack of staff.
This idea of economising on the Health Service is rather curious. As far as I can measure it, every time we shift prescriptions from the free to the paying side their cost rises. The reason is that it leads to waste. Everyone knows that doctors will not compel poor patients to pay these huge prescription charges but will prescribe for more than is necessary in order that those patients do not have to return and pay once again.
I am quite astonished at the way in which right hon. and hon. Gentlemen opposite talk about this 1s. increase. I was told recently of an old-age pensioner in my constituency who had to leave the chemist's shop because she did not have a shilling with which to pay for her medicine, even though she could recover it from National Assistance. She just had not that shilling, and she had to do without her medicine as a result. Another old-age pensioner had five items—that is 5s. They will now cost him 10s.—

Mr. John McCann: A fifth of the pension.

Mr. Woodburn: —and that old-age pensioner is not entitled to recover the charge.
How can any old-age pensioner pay these charges? I tell the Minister, quite seriously, that he will have to do something about this, otherwise the people who will be making all the economies will be those who will do without their medicines because they cannot afford to pay for them. I am quite sure that even hon. Gentlemen opposite will not want to economise at the expense of old

people who are unable to pay for their medicine—

Mr. McCann: That is what they do want.

Mr. Woodburn: That is the curious thing. If one went to an hon. Gentleman opposite and said that one knew of a person who was in need of £1 or £2, he would probably put his hand in his pocket and produce it at once. That has always been one of the curious things. As Jimmy Maxton said, if a wee waitress were in some sort of trouble, any hon. Gentleman opposite would give her £1 or £2 to help her, but when we introduced the Catering Wages Bill to protect all the wee waitresses the whole Tory Party was organised to "down" the wee waitresses. It is exactly the same in this case. If an old-age pensioner from a constituency told an hon. Gentleman opposite that he needed something, he would get it.
Who is to benefit by this saving? My hon. Friend the Member for Sowerby (Mr. Houghton) is quite right; it may be a so-called reduction in taxation. I remember that when food subsidies were abolished there was a reduction in Surtax and other taxes. One very wealthy man I know got exactly £50 a year, while other people got 6d. a week. In order to give that man £50 a year that he did not want or need, and those other people sixpence a week that made no difference to them at all, the whole economy was upset for years by abolishing the food subsidies. When all this is done, some wealthy person who does not need it will get the price of an extra dinner per week. This is supposed to be an extra inducement to him to work hard. It is such stupid nonsense that I cannot understand why anyone should put the argument forward.
It is quite true that the costs have risen, but why have they risen? I put a Question to the Minister the other day about this, and I understand that the net cost of prescriptions in real terms has risen by 24 per cent. Since 1950, there have been introduced into this country, or there have been discovered, new medicines and cures which, admittedly, are very expensive. They have put up the cost of prescriptions very considerably, but, of course, they have saved a tremendous number of lives.


Our tuberculosis hospitals and wards have been practically emptied, for example.
I can give some facts and figures in regard to what has happened in Scotland since 1947. Deaths from acute infectious diseases fell from 338 in 1947 to 29 in 1956. For diarrhoea illnesses, the number fell from 1,281 to 166, and for tuberculosis it fell from 4,095 to 801—practically wiped out. In the case of tuberculosis, of course, now that the disease has almost been wiped out, hospitals about to be built at the cost of millions did not need to be built because of the progress in new drugs and treatment which had been made. The incidence of pneumonia and bronchitis has come down, though, as we know, cancer and heart diseases have grown in importance. In 1855, one out of every 400 persons died of tuberculosis. Now, the rate is one in every 5,000, and it is decreasing.
If the Government want to save expenditure by transferring Government expenditure on to the private individual or to somebody outside, why pick on the Health Service? Why not take the Defence Services? Most of what the Government raises by taxation goes on providing defence. This would be an excellent purpose to provide for by a contribution on a stamp. Why not pick on defence expenditure and make people pay according to the amount of money they are having defended by this country? That would be a very good idea. Let those who need the defence most, who have the most to defend, pay according to their needs. Why put it all the Health Service? We have no objection to having a try at what I suggest. It would save quite a lot of expenditure by the Government, and they would be able to reduce Income Tax tremendously. It could be put on a stamp tax, and I hope that it would be very stiff for the Surtax payer who gets so much out of defence.
Why not stop paying for sanitation? Why not stop paying the high cost of clean water? There are all sorts of things on which the Government could save expenditure. No one really needs clean water or sanitation. The fact is, of course, that these things were introduced into this country because, from

the standpoint of real cost, they represent an economy for the nation, not a waste or extravagance.
If we talk of rising costs, we must bear in mind that the Service has been improving and we have had the benefit of the new and expensive drugs. Is the drug bill extravagant? It has gone up by well over 20 per cent. since 1950. We have had the miracle drugs which have reduced tuberculosis by 80 per cent. in twelve years. Also, doctors are able to treat many patients for pneumonia and tuberculosis at home, without having to send them to hospital, as they used to do. I believe that it costs £3 a day to keep some patients in hospital, and, of course, it is great saving if people can be cured at home. When treated with these drugs, however, tuberculosis sufferers may go back to work. As an economist, the Financial Secretry will realise that that is much more valuable than going into their graves. In the economic debate, we were told that we wanted to maintain the labour supply. Every man who can be maintained at work is an economy for the country, and this should be borne against the cost of these extra drugs. If the idea went as far as getting rid of sanitation and the rest to save Government expenditure, the hon. Gentleman would soon find that expenditure because of cholera, plague and the like would wipe out that idea of economy.

11.15 p.m.

I agree that excessive prescribing plays a part, but why should the patient be punished for that? I realise that where the auction sale goes on among doctors for patients, patients go along and persuade the doctor to prescribe for them; and, presumably, a doctor who prescribes more than another doctor collects more patients. That is why the Minister will not introduce free medicines for private patients. That would lead immediately to the auction sale procedure, and every doctor engaged privately would prescribe the "roof" for his patients to attract everybody else into his scheme. That could never be risked.

Over-prescribing is, I agree, a danger, but why punish the patient? That is the responsibility of the medical profession, some of whom may be sinners in this regard, as, I know, they were in my period of office. There is, however, no reason why old people should be deprived of


their medicine merely because some people misbehave.

The number of prescriptions dispensed in the United States and in Britain has gone down. In Britain, I understand, it has gone down by about 23 million. In the United States, however, the cost has gone up far more than it has done here. My latest figures show that in the United States, costs had gone up by 49 per cent., whereas in this country they were up by 36 per cent. We are supposed to admire the service in the United States, but the cost has gone up very much more there. The latest figures show that in the United States the average prescription cost for those who want private prescriptions is £16 7s. 7d. against the figure for this country of £4 4s. 1d. Everybody knows that, in the United States, to become ill is a sure way to disaster and ruin.

The question is, how do we measure the cost of the Health Service? Is it merely by the expenditure of the Government, or by the expenditure of the nation as a whole? Does anyone suggest that the nation as a whole would pay the doctors less if we did not have the Health Service? Will people have less medicine if more is charged for prescriptions? With the exception of the old people, I do not think so. The medicines will simply be paid for out of another pocket. The wealthy and the well-to-do will be able to pay for their prescriptions, but they would rather pay for them when they are well than when they are ill. Why should a person who is sick or ill have to be bothered with the cost of prescriptions when he is quite willing to pay for them when he is well? What the public ask the Government to do is to collect this money in the fairest possible way and to arrange for the payment for prescriptions as the doctor prescribes them. It is extraordinary that we should interfere between the doctor and the patient.

My hon. Friend the Member for Sowerby has made quite clear that the Government's method of payment is not the fairest possible way and that taxation according to ability to pay is the way in which it should be done. I agree that if the bill is incurred it must be paid for by the public as a whole, but the public are entitled to have the payment made in the most economical and best possible

way. I agree with my hon. Friend that the best way is to make the prescriptions the responsibility of the doctor and to ensure that in case of illness nothing interferes between the patient and the doctor.

The Conservative Party opposed the National Health Service, when the Act was going through the House, on the ground that it would interfere between doctor and patient. Members opposite delivered speech after speech saying that Labour Ministers would prevent doctors prescribing freely for the patients what they required. Their main spokesman at the time, Mr. Richard Law, now in another place, said:
But there are two principles to which we attach enormous importance. The first is the principle that the doctor's only loyalty and only responsibility should be to his patients. The second principle is that as far as his judgment is concerned, the doctor should be responsible to nobody else but himself, and certainly he should not be responsible to the State."—[OFFICIAL REPORT, 30th April, 1946; Vol. 422, c. 76.]

While I am not prepared to go all the way with him in that statement, I say that the Conservative Party has now completely deserted even the platform on which it opposed the Naional Health Service. It is now the Conservative Government, not the Labour Government, who are introducing deterrents to the administration of the Service in the best interets of the patients; it is they who are now interfering between doctor and patient—and the responsibility for it must rest upon them.

I ask them, even at this late stage, to think not so much of the cold economics of this but of the human aspect. I hope that the Minister, if he must insist on these increased charges, will take steps to see that people like diabetics and others, who have a large number of items on prescriptions, get some concession, and that old-age pensioners are not deprived of the very meagre increase they have had in their pension by having it transferred to increased charges for prescriptions.

Dr. Barnett Stross: I tried—

Mr. John Stonehouse: On a point of order, Sir William. May I seek an assurance from you that, so far as you are able, you will endeavour in


this debate to call speakers alternately from each side of the Commitee, in order that we may, if we have the co-operation of Members opposite, have a fair debate?

The Deputy-Chairman (Major Sir William Anstruther-Gray): It is entirely within the competence of the Chair who catches the eye of the Chair.

Mr. William Warbey: Further to that point of Order, Sir William. Is it not a fact that since this debate was opened by the Financial Secretary we have had a succession of three speakers from this side of the Commitee and no speaker from the benches opposite? Is that in accordance with the traditions of this Committee when we are concerned with raising taxation affecting 23 million people?

The Deputy-Chairman: As the Committee knows, that is no point of order.

Mr. William Hamilton: On a point of Order, Sir William. It is true that no Member opposite has risen to take part in this debate, though many of them have written in the Press and elsewhere in defence of these charges. We appreciate your position in that you cannot call people who do not rise. What would be the position if two or three of us on this side of the Committee went across to the benches opposite?

The Deputy-Chairman: As the Committee knows, that is not a point of Order. Dr. Stross.

Mr. Dudley Williams: On a point of order, Sir William. Would it be in order if some Members opposite came to this side of the Committee? They might be on the winning side for a change.

The Deputy-Chairman: Order. The Committee must get back to its business. Dr. Stross.

Dr. Stross: I tried to listen as attentively as possible to what the Financial Secretary said when he introduced the Motion. It was not easy all the time, and if I make a mistake in covering some of the things he said and in asking him some questions, I know that he will correct me, and I shall be delighted if he does so.
I think that he pointed out that the contribution was £40 million in 1946 and that that sum represented a levy of 10d. per head in the stamp. So far I am correct? Of course, in 1946 there was no Health Service. We were merely debating it and we had the Committee stage upstairs. The first full year was 1949–50, and I presume that I am right in saying that at that time the contribution was still 10d. and that it remained at 10d. all through the years until 1957, when it was doubled, and then raised to 2s. 4d. in 1958. Now we have this further rise. Now, instead of £40 million we are to raise £161 million in a full year?

Sir E. Boyle: Sir E. Boyleindicated assent.

Dr. Stross: Then I heard correctly, in spite of the Patronage Secretary who was sitting behind the hon. Gentleman at the time.
Why £40 million in a full year when the gross national product was £10,000 million and the gross cost of the Service was £381 'million—10 per cent. of £381 million gives roughly £40 million—and now 16 per cent. taken from the citizens by way of these contributions? On the figures I have received from the Minister this morning, following Questions which I put down for answer last Thursday—and I am grateful for the receipt of these figures which are as authoritative as can be—

Mr. Ross: The hon. Gentleman did not work them out; he got someone else to do that.

Dr. Stross: I know, but a great deal of trouble must have been taken by the civil servants, the workers, in the Ministry to prepare them, and I know that hon. Members will be interested to read them in HANSARD in the morning when they will be able to study them; the copy I have in my hand is the only copy I now have available.

11.30 p.m.

The Ministry gives the figures that in the first full year of its operation the gross cost of the Health Service was 3· 8 per cent. of the gross national product. That figure fell year by year until in 1959–60, the last year for which I have figures, it was 3· 6 per cent.—· 2 per cent. below that at the time when Stafford Cripps is supposed to have


economised on the Service. The hon. Gentleman told us that in the last accounting year the figure reached the 1949–50 level, so that in this last year we have reached the figure for the first full year.

That does not seem to be extravagance. When the Guillebaud Committee investigated costs of the Service, it said that between the first full year of the Service, 1949–50, and 1953–54 there was such an improvement by way of economies and streamlining that a true £67 million was saved in terms of goods and services. That was an important announcement. He will remember that the then Minister of Health, the right hon. Member for Thirsk and Malton (Mr. Turton), said some very pleasant things about the Committee and its findings and said how reassuring they were. He pointed out how gratifying it was to the House and to him in particular that the Service was so efficiently organised.

Why this sudden change whereby we are faced with a demand for £161 million which, I am told, is 16 per cent. or 17 per cent. of the total gross cost of the service for this next year, as against the 10 per cent. that we asked from men, women and children throughout these other years until the Conservative Government began to impose this type of charge? I do not think that I am going wide of the rules of order when I ask that we should get some explanation.

We have heard that we could get economies in drugs. Of that there is not much doubt. I was advised by the head pharmacist of one of the greatest teaching hospitals in this country, which is not far from this House, that by purchasing abroad only one drug, Tetracycline, he saved his hospital £1,000 a year; and that is just one item.

The Financial Secretary and the Minister will know that with group buying, or collective buying—and that does not mean bulk buying, which is something different—as is done by the Southwest Metropolitan Hospital Board, on an annual expense of £300,000, there is a saving of 10 per cent.—£30,000. Would it not be pleasant to have a 10 per cent. saving on the cost of drugs throughout the whole of the Service?

That would amount to about £9 million all over the country, a very useful sum of money.

Mr. Julian Snow: Is my hon. Friend aware that last October, for the first time, there was introduced into the standard contractual terms a clause which specifically prohibited the purchase by hospital groups of drugs from abroad, in flat contradiction to the provisions of Section 46 of the Act? [HON. MEMBERS: "Why?"] In order to prevent importations.

Dr. Stross: I am not sure about that. I rather doubt whether that clause is not common form for some hospital management committees.

Mr. Snow: Yes, it is.

Dr. Stross: I do not think it means a thing. At any rate, we have a right to tell the Minister and the Financial Secretary that they should look at these matters most seriously.
Now that I have been drawn as far as this on the question of drugs, may I say that I have an interest, and I wish to declare it, because for some years I have been a director of a small firm which sells drugs to the hospitals. Perhaps that is why I know something of the subject. I declare my interest frankly and openly.
I beg the Minister and the Financial Secretary to look at the problem to see whether we can get substantial savings, as I have said by encouraging collective buying and not paying extortionate prices. There is evidence that £30,000 a year is saved in one regional group by this means. I think it is possible that if such steps are taken by the Minister a salutary effect will be produced on the industry as a whole. Once we make people careful and make them realise that they must not exploit the taxpayer, all the way down the line we shall get real competition instead of a closed shop. I think that that would be a very good thing in this industry.

Mr. John Diamond: Can my hon. Friend, with his wide knowledge and experience of this industry, say whether it would be wholly beneficial also if the Government were to take powers to ensure that they knew the cost of manufacture of all goods supplied?

Dr. Stross: The Minister has told us that he will take steps towards achieving this. We urge him to do so as quickly as possible, and as thoroughly as possible. So far as we know he has not yet done it. He has not been Minister of Health for very long, but he must do this if he is to carry out his duties as Minister. He will never be forgiven if he does not act vigorously on this matter.
I mentioned that I had received information from the chief pharmacist at a great hospital. My hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) earlier gave fragmentary but interesting details of what is really happening to the people who have to pay increased charges for prescriptions, and what sort of people they are.
The Minister says that this charge is being imposed to keep the Health Service going and to make sure that hospital development is not impeded. It is therefore fair to mention this briefly. The chief pharmacist to whom I referred tells me that on 7th February he picked up at random a batch of 68 prescriptions and divided them into two groups. In one group he put those that he felt were once-and-for-all prescriptions; prescriptions for those people who would not come again. In the other group he put the prescriptions for patients who required frequent treatment. Of the total number of 68, 32 patients came in the second group. An analysis of those prescriptions showed that five patients required five items each visit; three required four items each visit; three required three items each visit; six required two items each visit; and the remaining fifteen one item each visit. He went on to describe the diseases involved, but I will not at this time of the night trouble the Committee with the details. Everybody knows them—diabetes, thyroid disease, rheumatoid diseases, psychiatric ailments, and so on. People suffering from any of those diseases must return to the hospital for treatment week after week, month after month, year after year, and some of them for a lifetime.
My informant, who is one of the great pharmacists in the country and a teacher of pharmacy at the university, is indignant about this charge. He wants the Minister to know, and we are telling him

now, that we are not talking about frivolous people; the people who are supposed to come and ask for their medicines for a bit of fun—like the story we heard earlier that orange juice is used for making cocktails. We were not, however, told whether it was the babies or the parents who drank the cocktails. The Minister will find that not only virtually every doctor but every pharmacist deplores what he has done. Those people know something about this subject. The situation with regard to the dispensing of drugs in our great hospitals is very different from what one finds outside in general practice. In nearly every great hospital the pharmacist receives a prescription from a consultant, but he is not bound by that prescription. He can substitute a suitable alternative.

The Minister of Health (Mr. Enoch Powell): The Minister of Health (Mr. Enoch Powell)indicated assent.

Dr. Stross: I see that the Minister agrees with what I am saying. He knows that it is in order to supply a suitable alternative.
That is a very proper thing. Why is there not some slight control outside, in family doctoring? I will give one example, which I think is atrocious, of the way in which money is wasted. Soluble penicillin is made by different firms, under different branded names. It is given to babies, and does not have to be injected. There are five or six different branded types. Incidentally, I raised this matter about a year ago, but I had no satisfaction from the former Minister of Health, who was a very gracious holder of that office. I asked him why it was that the chemist was compelled to prescribe exactly according to the trade mark or brand on Form E.C.10.
A mother may go, at night, to her doctor, who prescribes penicillin for her baby, which has pneumonia. She goes with that prescription to the chemist, who has four of the brands but not the fifth, which is the one on the prescription. He is not allowed to give the mother any penicillin. If it is too late at night to do anything he must try to get it in the morning, and she must go to him again then, before which time the baby's condition will worsen without this life-saving antibiotic. What


nonsense this is. [HON. MEMBERS: "Is it true? "] Of course it is true.
The right hon. Gentleman will have to find some means of providing cover for the chemist, so that he will not be sued by the owner of the trade mark mentioned on the prescription if he gives such a mother another brand. The doctor may also need to be covered. The right hon. Gentleman has been clever enough to try to force these increases on us, and he can surely try to protect the taxpayers by doing something on the lines I have suggested.
We are bitterly disappointed about the Minister's proposals. The right hon. Member for Woodford (Sir W. Churchill), after the publication of the White Paper of 1944, made a statement describing the sort of Health Service the country would have when victory had been won. He likened it to a great fire brigade, which could be called out by the tenant to the humblest cottage or the owner of the greatest mansion, and which would give equal service to both. But what is happening now? When the fire brigade calls, its members put their hands out and ask the tenant of the cottage and the owner of the mansion for money—and the same amount from both. They say, "We want 2s. 8d., or 2s. 10d. Pay, or we go back without giving you any help."

Mr. A. E. Cooper: I would not have made any contribution to this discussion had it not been for the speeches of the right hon. Member for Clackmannan and East Stirlingshire (Mr Woodburn) and the hon Member for Stoke-on-Trent, Central (Dr. Stross). There seems to be a feeling among hon. Members opposite that hon. Members on this side of the House are very hardhearted individuals and that our sole inclination in life is to grind the noses of the poor in the dust. I would like them to realise that in the majority of divisions there is a very substantial working-class element.

Mr. S. Silverman: I bet you did not tell them about this.

Mr. Cooper: Over the period of the last three General Elections, the Conservative Party has increased its majority substantially. Sitting opposite me

tonight is the hon. Member for Willesden, West (Mr. Pavitt), who is a resident in my constituency and knows something of my record over the last 26 years. During that time, I have represented the Borough of Ilford as a councillor, alderman or Member of Parliament, and throughout the whole of that time, in an area half of which is strongly working-class—including workers for the Ford Motor Company and similar firms—my majority has consistently increased.

11.45 p.m.

I very much regret that since about seven o'clock tonight hon. and right hon. Members opposite seem to have treated this whole subject in what I think is a very hilarious and utterly irresponsible manner—[HON. MEMBERS: "Oh."]

Mr. Laurence Pavitt: Mr. Laurence Pavitt (Willesden. West) rose —

Hon. Members: Sit down.

The Chairman (Sir Gordon Touche): Order. If the hon. Member for Ilford, South (Mr. Cooper) does not give way, the hon. Member for Willesden, West (Mr. Pavitt) must resume his seat.

Mr. Cooper: After the second Division took place—

Mr. Pavitt: On a point of order, Sir Gordon. The hon. Member for Ilford, South (Mr. Cooper) mentioned my name in his speech more or less as a reference for a statement he made. Am I not entitled to challenge that statement?

The Chairman: The hon. Member may be allowed to challenge the statement, but not if the hon. Member for Ilford, South does not give way.

Mr. James Callaghan: Further to that point of order, Sir Gordon. Would you remind the hon. Gentleman, who has been a Member of this House for a number of years, that when we are in Committee it is customary to give way. [HON. MEMBERS: "Oh"] it is so long since some hon. Members were here that they do not remember what is the practice of the House. It is usual to give way in Committee, especially when a reference is made to another hon. Member.

The Chairman: That is not a point of order for me.

Mr. S. Silverman: Has not it been the invariable custom of the House, whether we are in Committee or not, that if an hon. Member deliberately misrepresents what another hon. Member has said it is customary for the hon. Member who claims to have been misrepresented to be allowed by the hon. Member who has the Floor to explain what the misrepresentation was?

The Chairman: I do not think that arises on this point.

Mr. Cooper: The hon. Member for Nelson and Colne (Mr. S. Silverman) should know that the hon. Member for Willesden, West (Mr. Pavitt) has not spoken yet and so I have not misrepresented anything he has said. I simply called in aid his knowledge of my service to the borough that I have represented over the last twenty-six years, and—

The Chairman: Order. I think it would be better if the hon. Member returned to the Motion.

Mr. Cooper: Since about twenty minutes past ten certain hon. Members opposite have treated this very important subject with a great deal of irresponsibility. By a number of interruptions they have behaved like children. They have not conducted themselves in the manner of adult people or in a way in which the people of this country are entitled to expect from Members of the British House of Commons.

Mr. W. Hamilton: On a point of order, Sir Gordon. Will hon. Members on this side of the Committee be entitled to reply to these charges if they get an opportunity?

The Chairman: Hon. Members can make speeches when they are called.

Mr. Hamilton: Will they be in order, as the hon. Member for Ilford, South (Mr. Cooper) is in order, in referring to the behaviour of other hon. Members?

The Chairman: When the speeches are made we shall see whether they are in order.

Mr. Charles Loughlin: Further to the point of order, Sir Gordon. It is essential that

it should be ruled now whether that would be in order, whether it is possible to make references of this kind, lest the matter should come up again later. If the hon. Member for Ilford, South (Mr. Cooper) is entitled to do so, I assume that we shall be entitled to do so.

The Chairman: What I am dealing with at the moment is the speech of the hon. Member for Ilford, South, which has not been out of order so far. It is desirable, however, that the hon. Member should come back to the Resolution.

Mr. Hector Hughes: The hon. Member talks about irresponsibility. I do not think he was here when the Minister treated the Committee with great disrespect by galloping through his opening statement on the Resolution at such a speed that we could hardly understand what it meant.

Mr. Cooper: I cannot help it if my hon. Friend speaks in English which is not readily understood by Scottish hon. Members. I have been here all the time since seven o'clock and have listened to every word that has been spoken. If I may continue—

Mr. Ross: Is it in order to call an Irishman a Scotsman?

The Chairman: It is not out of order.

Mr. Pavitt: On a point of order, Sir Gordon. Is it in order for the hon. Member for Ilford, South to make statements about the way in which hon. Members on this side of the Committee are treating the debate when hon. Members behind him are exercising a considerable amount of levity?

The Chairman: That is not a point of order.

Mr. Cooper: The exchanges in the last five minutes sufficiently underline all I have previously said. It is deplorable—[HON. MEMBERS: "Hear, hear."]—that hon. Members should behave in this manner.

Mr. George Thomas: Would it be in order for the hon. Member for Ilford, South to refer to the health charges?

The Chairman: I have been trying to encourage the hon. Member to do that.

Mr. Cooper: The hon. Member for Ilford, South would be delighted to get on with his speech if allowed to do so.
What we are thinking about and discussing tonight is how the National Health Service of the future should be financed. I think the right hon. Member for East Stirlingshire was very constructive in the early part of his speech in which he laid down the difficulties with which the Labour Government were certainly faced in seeing how it should be financed. There is no doubt that this Service is developing, perhaps faster than many thought it would, say, ten or fifteen years ago when it was initiated. [Interruption.] I wish hon. Members would pay some attention to the facts and not try to tub-thump as if there were an election three weeks ahead. The facts are—[Interruption.] Hon. Members opposite can shout and scream as long as they like; it will not worry be in the slightest.
The facts are that the Health Service of this country under Conservative Governments in the last ten years has developed out of all knowledge and is the envy of the world. The question we face in this Committee of the House of Commons tonight is how its future development is to be financed. I admit quite frankly that it is a matter for argument whether it should be financed one way or the other. I do not deny the right of hon. Members opposite to their view that it should be financed by direct taxation, but surely in accepting that we have a right to expect them not to deny us the right to a wholly contrary doctrine.

Mr. Scholefield Allen: The Tories have the benefit of their election pledges.

Mr. Cooper: The standard of living in this country has changed substantially in the last ten years, and now is the time when we must consider realignment of the method in which these things are paid for. Let us not think that those who are described as the poorly paid people are being badly treated. They are doing remarkably well.

Mr. Cyril Bence: Come to my constituency and say that.

Mr. James Dempsey: How are they doing well?

Mr. Cooper: I wish that hon. Members would listen. I have no desire to detain the Committee for more than a few moments. Hon. Members opposite grumbled because no one on this side of the Committee wished to take part in the debate, but the moment someone makes a speech all they do is interrupt him. What do they want—one way or the other.
The so-called working-class in this country do very well indeed. About 4 million to 5 million pay no Income Tax. Many draw family allowances. They can earn a substantial amount of money before they have to pay Income Tax. Many live in council houses at rents which are subsidised by others. They get many services for which they pay nothing, other than their contributions in indirect taxation. We hear a great deal about the Surtax payers and others in the higher income groups, but let us not forget that £1,000 a year is not a particularly high income these days. In many industries in my area workers earn £20 a week. Moreover, many people earning over £1,000 a year send their children to private schools at no cost to the taxpayer.

The Chairman: Order. I am sorry to interrupt the hon. Member, but he is going very wide of the Motion.

Mr. Cooper: Many things are paid for by the higher income groups which are not a charge on the Health Service or the hospital service. Hon. Members opposite should recognise that these people make a considerable contribution. I sincerely believe that the time has come for a reconsideration of the methods by which the Welfare State is financed. We have reached the limit to which the ordinary contribution can be raised. I do not think that it can be taken any higher than the figures in the Bill without serious social consequences, particularly in wage demands. The figure in the Bill is about the maximum we can ask. We must consider how the Welfare State is to be financed in the future. Unfortunately, at present it is financed on the nation's vices—tobacco and spirits, to a considerable extent.

Mr. S. Silverman: On a point of order. In seeking guidance for those who wish to speak later, I would point out that the hon. and gallant Member has spoken about Surtax, school fees, and a variety of other matters, and now proposes to speak about tobacco and spirits.

Mr. Bence: And vice.

Mr. Silverman: How wide is the debate to be allowed to range?

The Chairman: I have made several attempts to keep the hon. Member for Ilford, South (Mr. Cooper) in order. He is going wide again. If he continues like this, I shall have to ask him to resume his seat.

Mr. Cooper: Sir Gordon, I have endeavoured in the face of considerable provocation to keep in order.

Mr. G. W. Reynolds: On a point of order. Earlier there were two hon. Gentlemen opposite who wished to speak, but the Patronage Secretary addressed them and they left. I am not sure that that was in order. Is it in order whilst an hon. Member is on his feet for the Patronage Secretary to tell him to sit down?

Mr. Silverman: In any case, why does he not?

Mr. Cooper: I do not know where the hon. Member for Islington, North (Mr. Reynolds) gets his peculiar ideas from. He must have very acute hearing, because my right hon. Friend and I had a quite different conversation. It would be a very good thing if we could have television at this moment.
I am trying to say two things. First, I think that the Opposition tonight have behaved in the most irresponsible manner possible, a fact which will be recorded in the country without any difficulty whatsoever. Secondly, my right hon. Friend is correct in what he has done. Further, I feel that we have now reached the limit in the individual contributions which people must be expected to make.

12 m.

Mrs. Eirene White: I start my speech by expressing my condolences with the Borough of Ilford, because if the residents there have heard speeches like that for twenty-six years they deserve

sympathy. Personally, I feel completely responsible and extremely indignant about this matter. It is a serious matter, on which my hon. Friends and I feel very strongly. If we sometimes seem to the hon. Member for Ilford, South (Mr. Cooper) to be a little hilarious, I assure him that is simply because we feel so strongly about this that we are perhaps a little over-emotional.
The Government have no excuse whatsoever for bringing this proposal forward at present. We have been told that now for the first time the Government are about to take steps to inquire into one of the most costly sections of the Health Service, namely, the supply of drugs. My hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross), who has great experience in this matter, was far too kind, not merely to the present Minister, but to his predecessor, the right hon. and learned Member for Hertfordshire, East (Sir D. Walker-Smith). He may have been a graceful Minister, but he clearly was not an effective one. Why did he not initiate far sooner the inquiries which the present Minister says he is about to initiate into the cost of drugs? The right hon. and learned Gentleman found that he could not earn enough on the Treasury Bench to pay his own contributions.

Sir Derek Walker-Smith: If the hon. Lady would display the fairness which is normally characteristic of her and would look at the facts of this subject, she would acknowledge that the three-year agreement with the pharmaceutical industry expired in June of last year. Obviously negotiations were in hand with the industry for the period after the end of the first trial period of three years. My right hon. Friend the Minister has successfully brought those to a conclusion in the new agreement as from the beginning of this year. It is wrong and unfair to say that no action was taken before. I hope that the hon. Lady would not suggest that I or any other responsible Minister would have acted in breach and contravention of an existing agreement.

Mrs. White: All I was saying was that the right hon. and learned Gentleman's agreement was ineffective, and that it is only now, apparently, that what we hope will be adequate investigations are to be made into the costings of these firms.
Surely, the collective responsibility not merely of the present Minister but of his predecessors in office should have led them to have satisfied themselves about the cost of drugs, not after but before they come to us saying that we should ask the public to pay these highly-increased charges and contributions.
Had these increased contributions been part of a package deal, of which we might have approved, I should not be objecting. The Minister might have said to us, "Costs have increased—we must find some extra finance. I do not intend to do anything about prescription charges, I shall not increase the charges for dentures, and the like. I shall ask for some small increase in contribution to be paid by people in employment, but I will not put an extra tax on the sick."
Had he done that, we might have been in a more amenable frame of mind about increased contributions—but not at all. The package deal we are being asked to approve is completely deplorable. We are now being asked to increase taxation—because, let the Government call it what they will, it is no different. We are increasing taxation on a flat rate with complete disregard of the people's capacity to bear that taxation.
Again, the representative of the Treasury might have said to us tonight, "We have been very seriously considering the financing of the social services. We think that the time has now come to give up the flat-rate basis. We think that it should now be placed on a footing in relation to earnings or in relation to income." Had he done that, I think that we could have had a reasonable discussion. There is at least some possible scope for argument there.
The Government, however, are not making any constructive or progressive changes; they are merely saying, "We want more." They have given us this list which is on the Order Paper now, and I ask the Financial Secretary—I will wait for the Patronage Secretary to take his seat—

Mr. Diamond: On a point of order, Sir Gordon. I have hesitated to interrupt my hon. Friend the Member for Flint, East (Mrs. White) until I thought that it might be convenient to her. Now that the Chief Whip has resumed his seat, Sir, may I ask, with deference,

whether you propose to disclose the conversation that has just taken place between you and the Chief Whip?

The Chairman: I do not intend to disclose any private conversation with anybody.

Mr. Diamond: Further to that point of order, Sir. May I take it that the normal course as to raising the question of whether you would accept a Motion for the Closure is for the question to be raised in a voice that can be heard throughout the Chamber? Can I take it that the conversation was a private conversation, and had no relevance to any proceedings in this Chamber?

The Chairman: It is not the concern of the hon. Member what the conversation was about.

Mr. Manuel: It is the concern of the Committee.

Mr. S. Silverman: Further to that point of order, Sir Gordon. I am sure you would agree that, if there were a conversation, however privately conducted, between the Patronage Secretary and the occupant of the Chair which had something to do with the conduct of the debate with which the Committee was then concerned, that would be something which the Committee would be entitled to know about.

The Chairman: My understanding of the position is that a private conversation is a private conversation.

Mr. Silverman: So long as it is about private affairs.

Mrs. White: When the Patronage Secretary interrupted the debate, I was about to ask the Financial Secretary to be good enough to explain why it is proposed that the increases in contribution which we are discussing should be 10d. per week for men and 8d. per week for women. I think that is the correct relationship. He will, I am sure, in the course of his duties, have studied the latest figures of average earnings of persons employed in this country. They were published quite recently. He will have observed that the average earnings of men at present are, in round figures, between £14 and £15 a week, but for women the figure is between £7 and £8 a week.
What is the justification for expecting women to pay what is admittedly somewhat Jess than men but considerably more than their proportion if the matter is judged according to their average earnings? Before we are asked to accept the figures put before us, he should explain to the Committee why it is that the man's contribution is to go up by 10d. whereas the woman's is to go up by 8d., when it is perfectly clear, since it is with women in employment and paying their own contributions that we are concerned, that women, according to the figures of average earnings published by the Government, are not in a position to pay as large a proportion in contribution as is suggested.

Mr. W. Hamilton: Will my hon. Friend be very careful about this? The Government might put the man's contribution up still further.

Mrs. White: That may be, but I am standing by the figures of relative earnings, and I want to know what the explanation is for this completely inequitable and disproportionate contribution from employed women in this country. At the other end of the scale, women have their income mulcted in Surtax. At this end of the scale, they have a raw deal by being asked to pay considerably more than they ought to pay, according to the figures.
There has been a good deal of discussion today about the increased cost of the Health Service. We have emphasised again and again from this side of the Chamber that, taken as a proportion of the gross national product—or whatever the economists choose to call it—the amount spent has not until this year even equalled the proportion of the national income spent on the Service ten years ago. Therefore, as my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) so admirably said in his winding-up speech at the end of our earlier debate, this panic Measure is really quite monstrous and unjustified.
I have not heard anyone explain so far that one of the reasons why there is additional cost in the Health Service, naturally enough, is, quite apart from increases of wages and so on, that there have been changes in the structure of the population. No one has, I think,

made the closely relevant point that we may properly expect that the Health Service would cost somewhat more today because of the increase in the proportion of young persons in the population as a result of the increase in the birth rate and because people are living longer.
It is precisely these two groups of persons who require most medical attention. Therefore, it would have been quite astonishing if we had not had some increase in the cost of the Service, for that reason alone.
One of the things which I find monstrous about the Government's proposals is that, even granting that they are making some slight concessions for pensioners and the like, the families with children will be most hardly hit. On the figures that are before us, the breadwinner will have to pay extra contributions in addition to the other forthcoming National Insurance contributions. At the same time, if his children are to have proper medical help, he must also pay considerably larger sums than he has been paying hitherto. It is completely unjustified for the Government to come to us tonight and expect us to agree to these figures in view of their lamentable handling of the situation.

Several Hon. Members: rose —

The Chairman: Mr. George Thomas.

12.15 a.m.

Mr. George Thomas: rose —

Mr. Callaghan: On a point of order. Before my hon. Friend begins his speech, may I draw your attention, Sir Gordon, to the fact that twelve of my hon. Friends rose to their feet? In view of the fact that at the end of a speech it is sometimes known for the Chief Patronage Secretary to ask for a Closure Motion to be accepted, will you take into account that if he does that, it would be, in the words of the Standing Order,
… an infringement of the rights of the minority … 
when twelve Members are still rising to their feet?

The Chairman: The hon. Member can rest assured that I shall take every consideration into account.

Mr. Stephen Swingler: Further to that point of order, Sir Gordon. May I make a plea on behalf of Members opposite and draw your attention to the fact that, owing to the browbeating by the Patronage Secretary, only one hon. Member opposite has so far had an opportunity to speak in the debate?

Mr. Warbey: Further to that point of order. Is it not perfectly clear, Sir Gordon—it has been obvious to every Member on this side—that the Patronage Secretary has been going round telling hon. Members opposite not to speak in this debate? Is this not a denial of the privileges of hon. Members?

The Chairman: That is not a point of order.

Miss Jennie Lee: Further to that point of order. May we depend upon you, Sir Gordon, to treat us not as two distinct parties? It will be obvious to you that not one Member from the party opposite rose to speak, whereas there were at least twelve of my hon. Friends on this side who were anxious to contribute to the debate.

Mr. G. Thomas: I rise to support my hon. Friends because of the deep feeling among my constituents about the proposals which are now before us. The question of increasing the contribution is one to which the hon. Member for Ilford, South (Mr. Cooper) referred in passing. Because I believe that this contribution is unfairly assessed and leaves gross injustices within the proposals of the Minister of Health, I propose for a moment to tell the Committee of an experience I had in my constituency during the past week.
When it was mooted in the Press that there was a possibility of a charge of 2s. per item per prescription being made, I visited an old-age pensioners' home in Cardiff where both the people concerned were chronic invalids. The week before, out of an income—which is exceptional among working-family old-age pensioners—of £8 a week, they had paid 8s. for their medical prescriptions, 4s. for each of the chronic invalids. They had made representations to their doctor, whom I well know, asking him what he could leave out of the prescriptions, because they could not afford to pay. These people will be faced—

The Chairman: This Financial Resolution does not deal with prescriptions.

Mr. Thomas: I was tempted to refer to them, Sir Gordon, because the hon. Member for Ilford, South went so far. At least, I am talking about health costs. This proposal for increased contributions which the Minister now asks us to approve is an attempt by him to undermine the whole basis of our welfare services. It means that the very rich will be relieved of a burden by the very poor having to pay more. The fact that last year in Wales alone £100,000 was reclaimed from the National Assistance Board by people who had paid 1s. for their prescription—I am using this as an illustration, Sir Gordon—proves that there is a vast army of people who cannot afford to pay the higher contributions the Minister is now asking for.
He should look again at the financing of the National Health Service, because I agree with my hon. Friend the Member for Cannock (Miss Lee) that the Chancellor of the Exchequer ought to be bearing the burden of the Service. The next thing that we will have is Members opposite following their noble Friend the Member for Dorset, South (Viscount Hinchingbrooke), who wants to make a charge on education similar to the health charges. It would be just as logical to levy contributions for education as it is to levy contributions for the Health Service.
The mark of a civilised community should be that we make our contribution to the welfare services according to our ability to pay. Instead, the wealthy, so well represented by the benches opposite, are being asked to make the same contribution every week as the lower-paid wage earners. It is a socially unjust and unfair proposal.
The Minister should, if the costs of the National Health Service are rising and if there is a special problem facing him, tell the better-off section of the community that, through taxation, they must make a greater contribution. After all, we ought to redistribute the national wealth in the welfare services, not take more from the very people who, in our so-called affluent society, find their low standard of living harder to bear.
It is true that for those people earning under £9 a week life is much harder than it was for the lower-paid wage


earners ten years ago, when the party opposite came in to office. Now the Government are widening the gap between the poor and the well off. By these proposals they are simply destroying the principle that the rich should help the poor, that the strong should help the weak—a principle embodied in the welfare services of which we have all been so proud.
It is an unhappy fact that, once the right hon. Gentleman was named as Minister of Health, we all knew that these proposals would come. His reputation went before him. I am ashamed to think that a man who comes from Wales—at least his forebears did; he claims the distinction of that—should so far forget the social principles in which we believe that he is prepared to throw on one side that principal which both sides have claimed at successive General Elections—the principle that we all help each other in time of sickness solely according to need. The Minister will find that the trade union movement will resent this proposal. He will inevitably find that he has thrown a spanner into the works of wage negotiations. It is all right for those well-padded hon. Members opposite to say—

Mr. A. R. Wise: While somewhat repudiating the extent of my padding, may I remind the hon. Member that it was not from this side of the Committee that there came the proposal that the starting level for Surtax should be £6,000?

Mr. Thomas: If it is to be in order to discuss Surtax—

The Chairman: It will not be in order.

Mr. Thomas: —I can assure the hon. Member for Rugby (Mr. Wise) that we will be ready to discuss Surtax if those who put this tax on the lower-paid workers of the country relieve Surtax payers later in the year. He will soon find the depth of indignation not only in the House of Commons, but in the country, and we warn hon. Members opposite that they have gone about as far as they can in pushing the workers around in a society in which, they keep reminding us, we have never had it so good.
These proposals will depress the standard of living of the people who can least afford every week to pay more and more out of their wages. Hon. Members opposite have never liked the Health Service and I remember that they used to keep us up night after night going through the Division Lobbies to vote on the Service. There are still hon. Members opposite who then made speeches agitating for the doctors not to co-operate in the Service, and some of them are now sitting on the Government Front Bench.
This proposal to maul a service which has been the envy of the world will not be forgiven. It is in harmony with Tory philosophy and with the Tories' idea that it is somehow wrong for people to have anything in the community without passing money over the counter. They think that there is a greater respectability in tablets being paid for over the counter than in having the community find its own decent way of helping those who are in need.
I know that it is no good to appeal to the better instincts of the Treasury and ask for further consideration to be given to this matter, but I can tell the Government that, so far as lies within my power, I will make it as difficult as possible, wherever I go in the country, for those who support a proposal which will make life harder and less just for the very people who are the producers in our society.

The Chairman: Sir Edward Boyle.

12.30 a.m.

Sir E. Boyle: Sir E. Boylerose —

Mr. George Brown: On a point of order, Sir Gordon. It must be clear to you that many hon. Members wish to put points to the Government and to get an answer to them. It must also be clear, especially after the private conversation that went on just now, that it could have been in the mind of the Patronage Secretary to prod the Financial Secretary to rise to his feet now with a view to closuring the debate immediately afterwards. Since the Standing Order provides that you are the custodian of the rights of the minority—and we are the minority here—Sir Gordon, any intervention by the Minister at this stage before, many of my hon. Friends have


spoken in the debate should not be regarded as a proper occasion on which to closure the debate.

The Chairman: It is quite normal to call upon the Minister to speak.

Mr. Brown: Further to that point of order, Sir Gordon. Since the Financial Secretary has not chosen to wait till the end of the debate, does the fact that he has risen to his feet preclude him from rising again, and does it preclude my hon. Friends who have not yet been called from speaking?

The Chairman: He can speak again with the leave of the Committee.

Mr. Swingler: Sir Gordon, you may not have noticed that back bench Members on both sides of the Committee rose to speak just now. In view of the fact that there has not been a fair balance between both sides of the Committee owing to the reluctance of hon. Members opposite to speak, would it not be fairer to allow the back bench Member opposite who did rise to speak?

The Chairman: That is not a point of order.

Sir E. Boyle: Sir E. Boylerose —

Mr. Callaghan: I think that we could get on much faster, Sir Gordon, if the Financial Secretary were allowed to utter one sentence. Could he tell us that it is not his intention to wind up the debate at this stage?

Sir E. Boyle: I can tell the Committee my intention. I have never understood that one has to ask leave of the Committee to rise. It is now about two hours since I last resumed my seat. I rose just now with the intention of answering some of the points which have been raised during the last two hours.

Mr. Callaghan: That is not quite the question I put. I appreciate the hon. Gentleman answering as he did, but I am asking whether he now intends to wind up the debate. Is it his intention to close the debate?

Sir E. Boyle: I cannot possibly know that. I have been in this House for a number of years and it is perfectly well known—

Mr. Fernyhough: On a point of order, Sir Gordon. We have every respect for you, but I want to ask you whether, having regard to the number of Members who have been trying to speak since a quarter-past ten, it is reasonable and fair that the Minister should, within a matter of two hours, be given an opportunity to make a second speech before Members who have been in the Chamber all day have had an opportunity to make a speech?

The Chairman: It is proper for the Minister to address the Committee.

Mr. Callaghan: Further to that point of order. We all agree that suspicion has been aroused because of the actions of the Patronage Secretary. None of us wants to cast any reflection upon your conduct in the Chair, Sir Gordon, but could we respectfully ask you this. You must be aware of the temper on this side of the Committee, and it would be reasonable to ask that you should not regard the occasion of the answer which the Financial Secretary is now seeking to give as being the end of the expression of opinion from this side of the Committee on this important question, when there are so many Members who have been sitting here for so long and who have been unable to express their views.
You will be aware, better than I, that if the Patronage Secretary should rise to his feet there can be no further debate. Therefore, the only opportunity we have of raising this matter and representing the strong views which are held on this side of the Committee is before he rises to his feet. I do not want to interrupt the Financial Secretary, but I think that his speech could proceed in amity if you could tell us that it is not your intention at the end of his speech to accept a Motion for the Closure.

The Chairman: I cannot accept a Motion for the Closure until it has been moved.

Mr. Callaghan: Further to that point of order, Sir Gordon. I think that we all understand that you cannot accept the Motion until it is moved, but, equally, when it is moved we cannot make any representations to you. Therefore, both you and we are in this difficulty. What would help us in deciding whether the Minister was being reasonable in rising


at this moment would be to know whether you consider that the debate has gone on sufficiently long for you to accept the Motion when it is moved. I think that it is reasonable to ask you what is in your mind about the length of the debate.

The Chairman: Sir Edward Boyle.

Sir E. Boyle: Sir E. Boylerose —

Mr. Michael Stewart: On a point of order, Sir Gordon. You told us a little while ago that the Financial Secretary would be able to speak yet again by leave of the Committee. Am I not right in supposing that he does not require any such leave; that he can speak as many times as he or the Committee wishes? May we take it, therefore, that his rising now in no way prejudices the proposition that he can rise again to answer the further points which we hope my hon. Friends will make?

The Chairman: Sir Edward Boyle.

Sir E. Boyle: Sir E. Boylerose —

Mr. Cyril Bence: On a point of order, Sir Gordon. The Motion says:
(c) so as to authorise the Treasury, instead of the Minister of Health and the Secretary"—
that is, the Secretary of State for Scotland—
to make regulations under the said Act of 1957.
Can we, as a Committee, demand that the Secretary of State for Scotland comes to that Box to explain the position in respect of Scotland?

The Chairman: The hon. Member cannot demand the presence of a particular Minister.

Mr. Fletcher: Further to the point of order raised by my hon. Friend, Sir Gordon, in helping you to apply your mind to the position if the Motion for the Closure is moved, might I draw your attention to the fact that there are a large number of highly complicated technical questions of a legal character which appear to me to arise on this Motion and which have not been put before the Committee. As the right hon. and learned Gentleman the Attorney-General is now here, I hope that we shall have an oppor-

tunity of ventilating these questions and receiving replies from him before the debate is concluded.

Mr. Ross: Mr. Rossrose —

Mr. Douglas Jay: On a point of order, Sir Gordon. In order to help you and to help the Committee, may I, through you, make this appeal to the Financial Secretary? He said that he rose to answer questions from my hon. Friends. As it is perfectly clear that there are many more questions which many of my hon. Friends wish to put, would it not solve the difficulty and help the Committee if the Financial Secretary refrained from making his answers until he had heard the further questions?

The Chairman: Sir Edward Boyle.

Sir E. Boyle: Sir E. Boylerose —

Mr. Ross: On a point of order. Sir Gordon, I know that it is rather difficult for you to answer this kind of question because the possibility of the Patronage Secretary moving the Closure is, of course, hypothetical. You have to decide whether to accept it, and once it is accepted, there can be no debate.
Would I be in order in asking you to bear in mind that this Motion applies to England, Wales and Scotland; that the Motion proposes to alter considerably the present duties and responsibilities of the Secretary of State for Scotland; and that hitherto we have had little or no consideration of the point of view of Scotland in relation to this? Prior to this debate, although the National Health Service in Scotland is represented in the Cabinet by the Secretary of State for Scotland, we did not hear from him the position relating to Scotland. I wish to address certain remarks in relation to this Motion to the Secretary of State for Scotland.

The Chairman: I did not call the hon. Member to make a speech; I thought that he was rising to a point of order.

Mr. Ross: Will you, Sir Gordon, as you make up your mind about any subsequent action you may take, bear in mind that we in Scotland have a point of view and still have not been able to express it?

Mr. G. Brown: I beg to move, That the Chairman do report Progress and ask leave to sit again.
I do so in order to draw attention to what seems to be a most remarkable and unsatisfactory situation. The Financial Secretary seems to be in an absolutely uncontrollable hurry to reply to a debate which clearly is not yet half way through. The issue we are debating is one of major importance to large numbers of our people—leaving out the party bitterness in the House. What we want first, is to be quite sure that my hon. Friends and hon. Members opposite have liberty to put their points of view and to know that the Minister will answer them. We have all been disturbed by the peregrinations of the Patronage Secretary. In the time that I have been in the House I have never seen one who managed to carry out his duties in a more arrogant, ostentatious and contemptuous fashion than this one.
He made not the slightest attempt to save your position. He troubled not a little about the risk of bringing you into conflict with this side of the Committee, by the way in which he quite loudly let everybody hear what he was saying. He walked round to the Chair while my hon. Friend the Member for Flint, East (Mrs. White) was speaking, as if neither she nor anybody else mattered, and then sat down and let everybody know that it was his immediate intention to move the Motion, "That the Question be now put", and then prodded to his feet the up-to-then somnolent figure of the Financial Secretary.
I would not trouble you with this Motion, Sir Gordon, except that it appears to me and to all hon. Members on this side of the Committee that—in the terms of the Standing Order—we are about to have a real infringement of the rights of the minority. My hon. Friend said that twelve Members were standing when the Financial Secretary rose to wind up the debate. That is a magnificent understatement. There were at least twenty hon. Members on this side of the Committee, there was the hon. Member for Heston and Isleworth (Mr. R. Harris) and there may have been others. Therefore the whole Committee has a desire to continue this debate, for perfectly proper reasons.
In moving this Motion I ask that we shall have a statement from the Patronage Secretary. If the Leader of the House were any longer cognisant of his duties he would be here, but such is the contempt every Minister is showing for Parliament at this stage that not one of them is concerned to bother about it at all. Earlier this afternoon we had two Ministers—the Minister of Health and the Financial Secretary—neither of whom answered a single point put in the debate, and both of whom read briefs that had been written before the debate began.

The Chairman: I am afraid that the right hon. Gentleman is going beyond the terms of the Motion he proposes to move. In any case, I do not propose to accept that Motion at this stage.

Mr. Brown: I do not know whether I am in the middle of a speech the conclusion of which you have not heard, Sir Gordon, in support of a Motion which you have accepted—

The Chairman: I am sorry. The right hon. Gentleman has misunderstood me. I have not accepted the Motion.

Mr. Brown: You have called me; otherwise I should not be making a speech. I have been addressing the Committee for five or ten minutes, moving a Motion, "That the Chairman do report Progress and ask leave to sit again". I have not yet finished my arguments. It may be within your competence, when I have finished, to say that you do not accept the Motion, but I submit, with respect, that in the middle of what I am saying you cannot tell me what your conclusion is.

12.45 a.m.

The Chairman: The right hon. Gentleman is going further than the Motion warrants. I was telling the right hon. Gentleman that it is not my intention at this stage to accept the Motion.

Mr. S. Silverman: On a point of order, Sir Gordon. I understood that my right hon. Friend had made it perfectly clear when he rose to his feet that he was moving to report Progress and to ask leave to sit again. The whole of his speech so far has been an argument in support of that Motion. Is not it a little too late for the Chair not to accept it? If the Motion is not to be accepted at all,


the usual custom is to reject it at once. It is too late to say that you do not accept it after a speech in support of it is half completed.

The Chairman: The hon. Member is mistaken for once. It is quite usual for an hon. Member to make a speech on a Motion which is not necessarily accepted.

Mr. Brown: Do I understand, since I am in the middle of my speech, that I may take it, Sir Gordon, that while you are not disposed to accept the Motion now, you are open to further arguments which I may put before you? I am submitting to you in support of this Motion that, in view of the contempt which Ministers have shown all through the day, and the arrogance which the Patronage Secretary has disclosed—it was really shockingly bad behaviour—we are entitled to ask for a statement from him, in the absence of the Leader of the House, as to the intentions of Her Majesty's Government. I have moved the Motion, "That the Committee do report Progress and ask leave to sit again." I have appealed to the Patronage Secretary for a statement and I ask that we get that, otherwise we on this side of the Committee must press our Motion.

The Chairman: I am afraid that I cannot accept the Motion at this stage.

Mr. Silverman: May I offer a rather different reason why you might consider accepting the Motion at this stage? I do not think—

The Chairman: Order. I have given my decision.

Mr. Swingler: May we know why?

Mr. Silverman: May I advance some considerations—

The Chairman: Order. I have given my decision on the matter.

Mr. Manuel: On a point of order, Sir Gordon. I think that the whole tension could be relieved if the Financial Secretary would tell the Committee that at a later stage he will answer the further questions which may be put to him.

Sir E. Boyle: I rose because it has always been the custom in debates in which I have taken part that, in a Committee, a Minister rises after two hours to answer some of the points put to him.

What happens after I sit down is entirely a matter for you, Sir Gordon, and the Committee—

Hon. Members: Sit down.

Mr. Frederick Lee: On a point of order, Sir Gordon. I distinctly heard the Financial Secretary say that it is the custom in the House, or in Committee, that after two hours a Minister rises to answer questions which have been put to him. I suggest that if we let that statement go by default it will be taken as a precedent and, whenever a Committee—

The Chairman: Order. Is the hon. Gentleman rising to a point of order?

Mr. Lee: With great respect, I think that we are discussing something which may establish a very dangerous precedent. My point of order was that the Minister used the expression that, after two hours of debate in a Committee of this type, it is usual for the Minister to reply to the questions which have been addressed to him. I am submitting to you as a point of order that if it is to be accepted as a precedent from now on that, whenever we have had two hours of discussion in any Committee, automatically the Minister will have the right to rise to answer the questions and then automatically the discussion will end—

The Chairman: I am sorry to interrupt the hon. Member, but perhaps I can help him. The Financial Secretary was not giving a Ruling. He was merely making a statement with which hon. Members may or may not agree.

Mr. Lee: I appreciate that, Sir Gordon, but when he made that statement, I put the point to you as Chairman of the Committee that if we allowed that to go by default it could be accepted as a precedent. May I address you on the point of order?

The Chairman: It cannot be accepted as a principle.

Mr. G. Brown: Further to that point of order. The statement made was that in the experience of the Minister it was the custom when there have been two hours of debate for the Minister to rise. The point of order we are putting to you—there is no one else to answer us so long as you are in the Chair and we


cannot save you from the responsibility—is, is there such a custom of the House that a Minister is fully entitled and called upon to rise after two hours of debate?

The Chairman: The Minister merely made a statement of what he regards as practice. Of course, as every hon. Members knows, there is no rule about it.

Mr. Brown: I beg your pardon, Sir Gordon, but with respect, I must press this. I heard what the Minister said. You have been good enough to tell me three times since then what the Minister said. I am clear about what the Minister said. We are asking you, is there any practice or custom this House, established or laid down, which either entitles or calls upon a Minister to reply after only two hours of debate? I am not interested in the Minister's views. I am asking you as custodian of the rights of the House of Commons. Is there any such practice or custom?

The Chairman: There is no particular rule.

Mr. S. Silverman: I want to put to you this point, Sir Gordon. Some questions have been put to you as to whether there is any customary practice when the House is in Committee for a Minister to reply to a debate after two hours. I want to submit to you that that question cannot arise here. Certainly there have been a number of speeches in the past two and half hours, but they have all been made from one side of the Committee.

The Chairman: Order. If the question does not arise, there is no point in discussing it.

Mr. Silverman: On a point of order.

Mr. Swingler: In order that we may have a democratic procedure, may I say that any suspicion of collusion between the Chair and the Government Whips can do great harm?

The Chairman: I did not hear the hon. Member.

Mr. Swingler: I wanted to ask you, Sir, whether you would give a straightforward assurance which, with respect, it is within your power to give, that, as

you know that many hon. Members, some on each side of the Committee, wish to put further points to the Financial Secretary, you will give those hon. Members an opportunity to put those points after the Financial Secretary has concluded?

The Chairman: It is quite improper for me to give such an assurance about some future Motion. I understand that the Committee wishes to discuss the Financial Resolution. Hon. Members seem to be a long time discussing points of order.

Mr. Callaghan: I rise because I think that all my hon. Friends would regret it if there were a collision between the Chair and hon. Members on this side of the Committee. Many of us are anxious to avoid that. The Financial Secretary has risen a dozen times to make his speech and each time he has been prevented by a point of order—

The Chairman: Is the hon. Member speaking to a point of order?

Mr. Callaghan: Yes, Sir Gordon. If I may reassure you, I am trying to expedite the business of the Committee. I am pointing out that it is not expedited if, every time the Financial Secretary rises to make his speech, he is interrupted by dissastisfied hon. Members raising points of order. As you have said that you are not free or able, or have not yet made up your mind, to take a decision about the ending of the debate, would not the Financial Secretary's reply be expedited if the Patronage Secretary gave an assurance that he does not propose to move the Closure?

The Parliamentary Secretary to the Treasury (Mr. Martin Redmayne): The Committee will realise that this is a rare treat for them. The right hon. Member for Belper (Mr. G. Brown) accused me, in fairly broad terms, of discourtesy to the Committee in a variety of ways. First of all—

Mr. S. Silverman: Is this a point of order?

Mr. Redmayne: I think I should be permitted to reply.

Mr. Silverman: On a point of order. What is the Patronage Secretary doing? Is he speaking to the Motion or raising a point of order?

Mr. Redmayne: I am speaking further to the point of order raised by the hon. Member for Cardiff, South-East (Mr. Callaghan). I will be brief, but I think that the Committee should be fair to me in this matter. I was accused of personal discourtesy to the hon. Lady the Member for Flint, East (Mrs. White). All I did was to walk from the Bar of the House, as any hon. Member might, to the place where I normally sit, without passing between the hon. Lady and you, Sir Gordon. That accusation is therefore quite unjustified. As for my other movements about the Committee, these are common form in the House. I have certain duties to perform on this side of the Committee, just as the hon. Member for Leicester, South-West (Mr. Bowden) has certain duties on the other side of the Committee. If we were not so heated, I think that no exception would have been taken.

1.0 a.m.

My hon. Friend the Financial Secretary, in accordance with ordinary procedure, proposes to answer some of the points which have so far been put in this rather complicated debate. As he said, in Committee that is a procedure which is normally followed. If, after that, I, as Patronage Secretary, choose to move the Closure in my own poor wisdom, it is entirely up to the Chair whether it is accepted. I move it at my own risk. If the Chair does not accept it, I look a precious ass. That is my business. Perhaps the Committee will now be good enough to let my hon. Friend reply to the points which have been made. We can then see what happens.

Sir E. Boyle: Sir E. Boylerose —

Hon. Members: No.

Mr. G. Brown: Sir Gordon, we are very grateful to the Patronage Secretary for what he said. If I misinterpreted his movements earlier, I withdraw my remarks completely. But the right hon. Gentleman could have expedited affairs if he had chosen—it would not have cost him much to do it—to give us the assurance for which my hon. Friend asked. We shall be delighted to hear the Financial Secretary at this stage if it is more convenient to him to deal with the points which have been raised so far, other points being raised by other hon. Members afterwards. If that is for his con-

venience, we are delighted to hear him and to facilitate that course.
It would make it so much easier for us, as the Patronage Secretary can clearly now see the misunderstanding which has arisen, if he will make it absolutely plain that he has not already made up his mind to close the debate afterwards. In the absence of such an assurance, some of the words he used sounded to us very ominous. It sounded to us as though he were a man whose mind was already closed. He and I have not been in the House of Commons a long time; we do not rate as old hands. However, we have been here long enough to know that on an issue of this kind, with this kind of temper and mood abroad, there has not been in our time a Government strong enough or powerful enough to over-ride it, except at tremendous additional inconvenience to themselves and everybody else.
There are many Bills to come. There are many Orders to come. There will be many opportunities. I suggest to the Patronage Secretary that in his own interests and those of his own side he might as well begin by being generous and let the Committee say its piece. Let hon. Members raise their points and allow an opportunity for discussion. It is already one o'clock in the morning. It cannot be a matter of great moment whether the Closure is moved now or the debate is allowed to continue.
I therefore ask the Patronage Secretary, speaking now as a House of Commons man and not as a partisan—[HON. MEMBERS: "Oh."] If hon. Gentlemen want the other mood, it can be obtained without any difficulty. That is the point of what I am saying. I appeal to the Patronage Secretary as a House of Commons man on a House of Commons matter, on a Bill the content of which could not be more telling, more important, or to many people more moving, to rise again and go a little beyond what he said just now. I ask him to assure us that, if we hear the Financial Secretary, as we shall gladly do, he will not then seek to use that as an occasion for closing the debate and shutting out the large number of Members on both sides who still want to continue the debate. I appeal to the Patronage Secretary to give us a second treat, and we will not ask him for any more too soon.

Sir E. Boyle: Sir E. Boylerose —

Hon. Members: No.

Sir Lynn Ungoed-Thomas: Sir Gordon, you told my hon. Friend the Member for Newcastle-under-Lyme (Mr. Swingler) that it would be improper for you to give an assurance to the Committee about the Closure. May we be assured that what would obviously be an improper assurance, according to you, has not been given to the Patronage Secretary?

The Chairman: No application has been made to me for the Closure, and I have given no assurance.

Mr. Longhlin: Further to that point of order. In view of the Patronage Secretary's statement, from which we can gather that immediately the Financial Secretary sits down he intends to move the Closure, may we now revert to the question whether you are prepared to give us an assurance that you will not accept the Motion at this stage, as so many of us want to speak on these issues?

The Chairman: I cannot give any assurance about hypothetical circumstances.

Sir E. Boyle: Sir E. Boylerose —

Hon. Members: No.

The Chairman: I hope that the Committee will conduct its proceedings in a reasonable fashion.

Mr. Loughlin: On a point of order, Sir Gordon. With due respect to you, Sir, I cannot at this stage conduct myself in a Parliamentary manner in view of the conduct of the right hon. Gentleman opposite, and I will risk being named—although with no disrespect to yourself, Sir Gordon.

Sir E. Boyle: Sir E. Boylerose —

Hon. Members: No.

The Chairman: I hope that hon. Members will allow the debate to be conducted.

Sir E. Boyle: Sir E. Boylerose —

Hon. Members: No.

Mr. Redmayne: Sir Gordon. This is a most difficult situation, and I am sorry

that we find ourselves in this difficulty. The fact of the matter is that this debate is only, as it were, a paving stage for a Bill which will have a Second Reading and a Committee stage on the Floor of this House. It is, therefore, in a different set of circumstances from many of our stages of procedure.
As Patronage Secretary, I am in an awkward position. I said before that responsibility for moving the Closure is entirely mine, and that it is up to me to risk whether or not it will be accepted. As it is obvious that at this moment we shall not make any progress in this way, I must put the matter to the test.
I therefore beg to move, That the Question be now put.

Hon. Members: No.

The Chairman: The Question is, That the Question be now put.

Mr. Callaghan: Sir Gordon—[Interruption.]—I beg to move, That the Chairman do now leave the Chair.

Hon. Members: Send for Mr. Speaker.

Question put, That the Question be now put:—

The Committee proceeded to a Division —

Mr. Callaghan(seated and covered): On a point of order, Sir Gordon. Many minutes ago, you called the Financial Secretary to speak in this debate. He was then interrupted by several points of order, some, perhaps, more irregular than others, and at the end of one of them the Patronage Secretary rose, as he said, to reply to a point of order which I had raised. I think we all appreciated that, but is it not an abuse of the procedure—indeed, I go further—is he in order in actually rising at that moment, when the Financial Secretary had been called, in order to move "That the Question be now put"? It may be that he is within order, Sir Gordon, but do you not think that it is an abuse of the rules of order? In the circumstances, I beg to move that you do leave the Chair.

The Chairman: The Question is, "That the Question be now put."

Mr. GIBSON-WATT and Mr. CHICHESTER - CLARK were appointed Tellers for the Ayes; but no Member being willing to act as Teller for the Noes The CHAIRMAN declared that the Ayes had it.

Mr. G. Thomas: (seated and covered): On a point of order, Sir Gordon. May I ask whether I heard you announce Tellers for both sides? Also, may I ask whether you will allow us to pursue the matter of whether the debate is to be continued?

The Chairman: That matter has already been decided.

Hon. Members: When?

Question put accordingly.

The Committee proceeded to a Division —

Mr. BRYAN and Mr. J. E. B. HILL were appointed Tellers for the Ayes; but no Member being willing to act as Teller for the Noes The CHAIRMAN declared that the Ayes had it.

Resolved,

National Health Service Contributions

1. That the rates of National Health Service contributions be increased by substituting the rates specified in the Table set out below for the rates set out in the Schedule to the National Health Service Contributions Act, 1958.

2. That it is expedient to amend the National Health Service Contributions Act, 1957—

(a) so that enactments relating to national insurance passed subsequently to the National Insurance Act, 1956, shall be deemed to have been included among the National Insurance Acts referred to in the said Act of 1957;
(b) so that the provisions of the said Act of 1957 as to the expenses of the Minister of Pensions and National Insurance shall be deemed to have applied to the expenses of other government departments and to have included provision in respect of accruing liabilities for pensions and other payments and in respect of the use of premises belonging to the Crown; and

(c) so as to authorise the Treasury, instead of the Minister of Health and the Secretary of State, to make regulations under the said Act of 1957.

3. That there be paid into the Exchequer any increase in the sums so payable by virtue of the said Act of 1957, being an increase attributable to the increases in rates of contributions and the amendments referred to in the preceding provisions of this Resolution.

4. That it is expedient to make provision for other matters incidental or supplementary to the matters aforesaid.

TABLE


Description of person.
Weekly rate of contribution.



s.
d.


1. Employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment
2
8½


2. Employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment
2
0½


3. Employed boys and girls under the age of 18
1
4½


4. Employers

7½


5. Self-employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment
2
10


6. Self-employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment
2
2


7. Self-employed boys and girls under the age of 18
1
6


8. Non-employed men between the ages of 18 and 65
2
10


9. Non-employed women between the ages of 18 and 60
2
2


10. Non-employed boys and girls under the age of 18
1
6


Resolution to be reported.


Report to be received this day; Committee to sit again this day.

ADJOURNMENT

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Hughes-Young.]

Mr. George Brown: On a point of order. [Interruption.] Mr. Deputy-Speaker, on a point of order. It will be very clear to everybody that some discussion was going on up there between you and one of the Government Whips which was quite inaudible to everybody else. We have no idea, Mr. Deputy-Speaker, what business you are about to allege you conducted with that hon. Gentleman during that inaudible conversation.
In view of the whole proceedings of the last twenty-five minutes, which I regard as disgraceful, I beg to move that you leave the Chair and send for Mr. Speaker. [Interruption.]

Mr. Deputy-Speaker (Sir Gordon Touche): Order. Order. [Interruption.]

Hon. Members: Leave the Chair.

Mr. Deputy-Speaker: Order. [Interruption.] Order. We are now on the—[Interruption.]

Hon. Members: Leave the Chair.

Mr. Brown: Send for Mr. Speaker. [Interruption.] Mr. Deputy-Speaker, I have claimed to move a Motion, which I did with the greatest reluctance. It will be apparent to everybody that we have got into difficulties because of the absence on the Government side of anybody with a sense or a touch for the mood of the House. If we are forced, as my hon. Friend said earlier, to come into collision with you, Sir, as the only way of dealing with this, it must be, as I tried to say to the Patronage Secretary, very apparent that the Government will lose more time while that Motion is dealt with than they could possibly have lost after one o'clock in the morning—such a Motion as we might now feel forced to put down, through no reason of yours, Sir, but, nevertheless, you were put into the impossible position. In my personal judgment, you were put into the position where, I believe, you then acted as you did, by them. But because of that, such a Motion will be taken in the full hours of the business of the House.
It must be apparent to the Leader of the House, who has only just arrived,

that something has happened which requires his intervention. May I ask the Leader of the House whether he has anything to say to us, failing which, Sir, I am bound to press you for an answer to the Motion which I not only claimed to move, but had moved, which was that you should leave the Chair, after having sent for Mr. Speaker.

Mr. Deputy-Speaker: The Question before the House is, "That this House do now adjourn".

Hon. Members: No.

Mr. Brown: On a point of order. Mr. Deputy-Speaker, this is now being made quite impossible. When I moved my Motion, I pointed out to you, without any reaction from you, that you and a Government Whip had had a private conversation there which no Member of the House had heard. I pointed out to you, Sir, that anything which you were about to declare which had passed between you two could not possibly be regarded as business of the House or a decision of the House. If, as I understand it, you are now purporting to say that a Motion was moved and accepted by you while I was on my feet, without anybody raising his voice and without anybody in the House hearing it, then I am bound to say to you that there must be a Motion. This is behaviour in the Chair which I have not seen in fifteen years.
I moved, in the full hearing of everybody—which the Government Whip did not do—that you send for Mr. Speaker. It was the only Motion heard to be moved. It was the only Motion anybody heard. Nobody heard your private conversation.
I persist in claiming my right to move that you send for Mr. Speaker and do not purport to carry the House on some private conversation of your own that you have—[Interruption.]

Mr. Deputy-Speaker: No such Motion is in order and I declare the House adjourned.

Grave disorder having arisen in the House, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to Standing Order No. 24 (Power of Mr. Speaker to adjourn House or suspend sitting).

Adjourned at twenty minutes past One o'clock.